Tell us about your hair, issues/goals and routine so we can help you out

Name

Email *

Are you completing this for yourself or someone else? *

How old are you (or the person)? (We ask this because age sometimes plays a factor in some hair conditions)

What hair issue/goal do you (or the person) currently have? *

If other, please specify

What is the current state of your hair (or the persons)? Select all that apply *

How often do you/they use heat on your hair? *

How do you/they usually wear your/their hair? *

If other, please specify

How often do you cleanse your hair with shampoo? *

If other, please specify

How often do you co-wash? *

If other, please specify

How often do you deep condition? *

If other, please specify

How often do you moisturise and seal your hair? *

If other, please specify

How often do you do a protein treatment? *

If other, please specify

How often do you clarify your hair? *

If other, please specify

If you clarify your hair, what do you use?

If you relax your hair, what kind of relaxer do you use?

If unsure, please include the full name of the relaxer per the pack

Tick all that apply *

What products do you/they use currently? (Please list the product names as stated on the pack) *

Include a photo of your shampoo ingredients (back of the shampoo bottle) *

Include a photo of your deep conditioner ingredients *

Include a photo of your leave in/moisturiser ingredients *

Include a photo of your oil ingredients *

Include a photo of any other product ingredients *

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Hair and Scalp Treatment