Hair & Scalp Consult
Hi, I’m Tessa! 💜 After experiencing firsthand how much confidence can come from understanding and caring for your hair and scalp, I became passionate about helping others do the same! This form will help me learn more about your hair goals and current routine, so I can provide personalized recommendations tailored to your unique needs! Healthy hair starts at the scalp. Fill out the form below, and let’s begin your journey to healthier hair, and a more confident YOU, together.✨
My roots & scalp are:
Dry
Oily
Combo
Normal
My hair texture is:
Fine
Medium
Thick
Coarse
I’m not sure
My natural hair type is:
Straight
Wavy
Curly
Coily
I’m not sure
My ends are:
Split
Dry
Damaged
Healthy
My hair is colour and/or chemically treated:
Only coloured
Only bleached
Both
None of the above
I wash my hair:
1-2x per week
2-3x per week
3-4x per week
Everyday
Multiple times per day
I apply heat to my hair:
Never
Once in a while
2-3 times per week
Daily
I prefer to style my hair:
Air dry + Heat styled
Blow dry + Heat styled
Only air dry
Only blow dry
Other
My main hair/scalp concerns are: (select all that apply)
Heat damage
Split ends
Frizz
Oily
My hair won’t grow
Thinning and/or Balding
Irritation and/or Itchiness
Receding
Chemically over-processed
Brittle and/or Breaks easily
Other
My top hair goals currently include: (select all that apply)
Growth
Shine
Hydration
Volume
Manageability
Damage repair
Thickness/Density
Less frizz
Longer times between washing
Colour maintenance
Texture definition (wavy/curly/coily)
Less buildup
Clean scalp
Other
I’m interested in partnering with MONAT:
*
Yes! Please contact me
Maybe, I want to learn more
No, thank you!
Your Budget!
We can start off by getting you the products you desire, within your budget! We start off with a minimum spending of $150, (not including discounts), which easily gives you 4-6 months of product to start your hair care journey with confidence! ✨
My budget is:
Please Select
<$150
$150-$175
$175-$200
Unlimited; my hair needs any help it can get!
Get to Know You!
Please take a moment to fill in the following information, to make sure we stay connected in reaching your hair goals!
My name is:
*
First Name
Last Name
My email address:
*
example@example.com
You can reach me best by:
*
Instagram
Facebook
Text
Other
My social media handle is:
*
Instagram username, name on Facebook, etc.
My phone number is:
*
Please enter a valid phone number.
Format: (000) 000-0000.
I live in:
*
Street Address
Street Address Line 2
City
Province/State
Postal/Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
I’m interested in the following MONAT product lines:
*
Skincare
Health/Wellness
Men’s line
Children’s line
Pet line
Not right now
Other
You’re all finished!✨
Once you hit ‘Submit’, I will receive a notification where I will review your answers and create a personalized product list, that best supports your hair + scalp, goals and needs!
SUBMIT
Thank you🫶🏻
I can’t wait to be in touch with you!
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