JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Hair Quiz | Consultation
We are the #1 hair care brand in North America
Naturally based products that grow and restore hair
First and only anti-aging - clinically tested - hair care in the world!
We Are Modern Nature - bringing together nature & science
NO SILICONES! NO SULFATES! NO PARABENS! NO HARSH CHEMICALS! NO HARMFUL FRAGRANCES! GLUTEN FREE! 100% VEGAN! LEAPING BUNNY CERTIFIED! NATIONAL HAIR LOSS ASSOCIATION APPROVED!
Answer the questions below to find the custom treatment system specific to your wants and needs.
Let's get started!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name ( First & Last)
*
Your answer
What is your birthday ?
*
MM
/
DD
/
YYYY
Email- for sending you suggested products
*
Your answer
Is your hair strand diameter
*
Fine
Course
Average
Other:
How dense is your hair?
*
Thin
1
2
3
4
5
Thick
Is your hair
*
Curly
Wavy
Straight
Is your hair color treated?
*
Yes
No
Is your scalp
*
Oily
Dry
Normal
Other:
Is your hair
*
Oily
Dry
Super dry and breaking
How often do you wash your hair?
*
Daily
Every 1-2 days
3 days +
Other:
What’s your biggest hair concern/ issue?
*
Your answer
How do you normally style your hair, air dry? Any product used? Heat?
*
Your answer
What are your hair transformation goals? Less frizz, more volume, growth, repair, etc
*
Your answer
How often do you use heat styling?
*
Your answer
Do you have any plant or nut allergies? If so, list them below
*
Your answer
Are you interested in a detailed explanation of what products I recommend for your hair type and how they’ll fix your concern?
*
Yes, DM me !
No
Other:
If so, how do you prefer to be contacted
*
Instagram
Facebook
Text
Not Interested
Other:
How can I contact you? Please provide instagram handle, phone #, or Facebook name ?
*
Your answer
I’m interested in :
*
Purchasing the products
Selling the products
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms