Hair Consultation Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Preferred Method of Contact?
Phone
Text
Facetime
Email
1. Is your Scalp Dry or Oily?
Dry
Oily
Neither
1a. If it is Dry - Is it Itchy or Flaky?
Itchy
Flaky
Neither
1b. If it is Oily - How often do you wash your hair? Put N/A if not applicable
2. Do you have Sensitive Skin or a Sensitive Scalp?
Sensitive Skin
Sensitive Scalp
Both
Not Sensitive
3. Is your Hair Density Thin, Medium, or Dense (A lot of it)?
Thin
Medium
Dense
4. Is The Texture Fine, Medium or Course?
Fine
Medium
Course
5. Frizzy or Not Frizzy?
Frizzy
Not Frizzy
6. What do you need more of. Moisture or Volume?
Moisture
Volume
Both
7. Split Ends or No Split Ends?
Yes
Not To Many
No
8. Damaged or Not Damaged?
Damaged
Not Damaged
9. Processed or Not Processed? (Colored, Chemically Treated)?
Colored
Double Processed (Color & Highlights)
Highlights Only
Not Processed
10. Heat, Air Dry or Both?
Heat
Air Dry
Both
11. Are you Allergic to Nut or Soy?
Nuts
Soy
Both
12. Main Concern With Your Hair?
13. Are You Interested in Using These Products and Making Money While Sharing Them?
Yes
No
Maybe
14. Please, Upload A Picture Of Your Hair or You can text it to me at (914) 482-7661 or email me at emendez2318@gmail.com (Needed to make a proper recommendation on your hair).
Browse Files
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15. Are You Interested In Anti-Aging Skin Care Products?
Yes
No
16. Would You Like To Take My Body Well Quiz?
Yes
No
Submit
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