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Pre-consultation form contact For hair care

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Name: *

Phone number *

E-mail address: *

Do you have dry hair?

Do you experince shedding?

Do you experience slow growth?

Do you have breakage?

Do you take hair vitamins?

How often do you apply treatments to your hair? *

List all products you use on your hair and scalp? *

How do you style your hair? *

Do you wear weave, braids or tight styles? *

How is your scalp? Dry, dry itchy, dry itchy flaky, oily, oily flaky, normal?

Would you be interested in an in-person treatment(s) or home DYI treatment(s) with support?

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