healthy hair and skin questionnaire
Let's get you started on reaching your very own personal hair and skin care goals with a customized anti-aging haircare and/or skincare system.

WHO WE ARE: We are the fastest growing premium hair and skin care line in North America, and the only anti-aging hair care line that is clinically tested in the world. Our Skin Care line is both dermatologically & ophthalmologically approved. We've added a Wellness Line as well to complement a more 360 approach to inner health & outer beauty.

WHAT WE DO: We offer natural based products that are clinically backed and scientifically proven to promote healthy hair growth, and reverse damage to the hair's healthiest state. Our skin care promises to: Increase Brightness & Radiance, Reduce Age Spots, Improve Skin Tone, Reduce Elasticity, Reduce Fine lines & Wrinkles, Improve Texture,  Increase Moisture & Hydration

WE SAY NO TO: Harmful Ingredients, colors, and Fragrances. No Parabens, Gluten, SLS/SLES, Cyclic Silicones, BHT, DEA/MEA, Phthalates, Petrolatum, Mineral, or Wax, Triclosan, Plastic Microbeads, Formaldehyde Releasers

OUR PRODUCTS: 100% vegan, gluten free, and Leaping Bunny Certified. Hair Care provides 88% more manageability and shine after the first wash, and will cut your blow drying time in half. Skin Care guarantees to reduce wrinkles by 15%.

WHO ARE THESE PRODUCTS FOR: Women, Men, Kids, & Dogs.

WHERE CAN I SEE PROVEN RESULTS: Please head to Instagram & look up the hashtag #monatbeforeandafter for just under 40K tags of incredible before and after results. Photos for specific results can be requested.

Each product is specific to hair & skin type and needs please fill out the below quiz as accurately as possible.
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email address *
first & last name *
phone number
instagram handle *
what GOALS would you like to achieve with your hair? please check all that apply
your hair is
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hair type
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if you are a curly girl, what do you interpret your curl pattern to be?
is your hair dry?
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is your hair frizzy?
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how often do you wash your hair?
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if you replied every day, explain why?
is thinning / balding a concern?
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do you get oily roots easily? (after 1 - 2 days?)
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do you have split ends?
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how often do you use hot tools? (straighten, blow dry, curl?)
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what shampoo / conditioner brand do you currently use?
do you currently use styling products, if so what ones? (type n/a if you use none)
any other details about your hair that was missed, describe below
are you interested in the anti-aging skin care line?
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my skin is currently
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im looking to
do you have any allergies? does anyone in your household have a nut allergy?
would you be interested in hearing more about...
how did you hear about this offering?
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if referred by a friend, please write below by who:
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