Juliette’s Healthy Hair Consultation

Healthy Hair

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What is your name?*

First NameLast Name

Phone Number*

Area CodePhone Number

Email

example@example.com

What is your Instagram handle?

Great! Now, What is your hair type?*

StraightWavyCurlyCoiled

Please describe your hair density:

Is your hair color treated?*

YesNo

Is your scalp:*

OilyDryNormal

How oily does your scalp get within two days of washing?*

Not OilySomewhat OilyVery Oily

How often do you wash?

Every dayEvery other dayEvery 3-4 daysOnce a week +

Is dandruff or flakiness an issue?*

YesNo

Primary & Secondary Concern*

How often do you apply heat?*

NeverOnce a week2-3 times a weekDaily

How do you prefer to style your hair?*

What products do you use to style your hair?*

What is your biggest concern?*

What are your ultimate hair goals?*

What are you interested in?*

Purchasing the productsEarning an extra income (+30% off!)

Are you interested in our other beauty lines?*