HEALTHY HAIR CONSULT
WELCOME TO YOUR PERSONALIZED HAIR CONSULTATION!
LOOKING FOR HAIR REPAIR? FRIZZ FREE STYLING? GROWTH?
YOU'VE COME TO THE RIGHT PLACE.
WE ARE BRINGING YOU THE BEST OF BOTH NATURE & SCIENCE THAT TOGETHER CREATES ONE OF THE ONLY ANTI-AGING, CLINICALLY TESTED HAIRCARE LINES IN THE WORLD.

FREE OF SILICONES, SULFATES, PARABENS, HARSH CHEMICALS & HARMFUL FRAGRANCES.
TO MAKE THINGS EVEN BETTER - THE PRODUCTS ARE GLUTEN-FREE, 100% VEGAN & LEAPING BUNNY CERTIFIED.

COMPLETE THE SURVEY BELOW TO GET YOUR HAIR PRODUCTS CUSTOMIZED TO YOU!

XO
Sign in to Google to save your progress. Learn more
FULL NAME & IG HANDLE *
PHONE NUMBER *
DESCRIBE YOUR HAIR DENSITY: *
THIN
THICK
IS YOUR HAIR: *
IS YOUR HAIR COLOUR TREATED? *
IS YOUR SCALP: *
IS YOUR HAIR EARS DOWN: *
HOW OFTEN DO YOU WASH YOUR HAIR? *
IS DANDRUFF AN ISSUE? *
HOW OFTEN DO YOU APPLY HEAT/STYLE? *
WHAT IS YOUR BIGGEST HAIR CONCERN? *
WHAT ARE YOUR MAIN HAIR GOALS? *
I'M INTERESTED IN: *
Required
ARE YOU INTERESTED IN OUR OTHER BEAUTY LINES?
Clear selection
WOULD YOU RATHER ME REACH OUT: *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms