How would you describe your scalp condition?
What is the current state of your hair?
FRIZZYBRITTLECHEMICALLY DAMAGEDDRYUNMANAGEABLEANY OTHER
ANY PARTICULAR SCALP RELATED CONCERNS THAT BOTHERS YOU?
HAIR LOSSSCALP SENSITIVITYDANDRUFFANY OTHERUNMANAGEABLEANY OTHER
Any particular scalp related concerns that you would like to highlight?
Hair LossDandruffScalp SensitivityAny Other
Are you a fan of colored hair? if yes, how often do you get your hair colored?
OftenSeldomI don’t get my hair colored
Are you indulging in any type of activities that might put your hair in jeopardy?
Sports ActivitiesSwimmingGymDanceAerobicsNo ActivityAny other activity that include exposure to sun, salt/chlorine water, etc.
What’s your present hair color?
Have your hair gone through any of these services?
Keratin treatmentSmootheningPermingRebondingAny Other
How often do you style your hair with thermal tools?
EverydayOnce/Twice a weekVery SoonDon’t Use thermal tools
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