HEALTHY HAIR WITH RACH

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Birthday* This field is required.

Date

5

Instagram Handle* This field is required.

6

Gender* This field is required.

Male

Female

7

What is your hair density?* This field is required.

Thin

Thick

In-between

8

What is your hair type?* This field is required.

Straight

Wavy

Curly

9

Is your scalp:* This field is required.

Oily

Dry

Normal

10

Is dandruff an issue?* This field is required.

Yes

No

Sometimes

11

What is your hair texture?* This field is required.

Frizzy

Dry

Both

12

How often do you wash your hair?* This field is required.

Daily

Every 1-2 days

Every 3+ days

13

How often do you use heat tools on your hair?* This field is required.

14

How do you dry your hair?* This field is required.

Air dry

Blow dry

15

What is your biggest concern/issue you’d like to address?* This field is required.

16

Are you interested in a detailed explanation of what products we would use for your hair concerns and how we can fix them?* This field is required.

Yes, text me

Yes, DM me

17

I’m interested in:* This field is required.

Transforming my hair

Becoming my own boss

Both