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Hair Questionaire

We're excited to jumpstart your Holistic Hair Growth Journey! Please make sure that you enter your name at the end of the form to receive an email of your results and dietery information.

What is your age range?
Do you get regular trims?
Last Trim?
How would you describe your scalp?
What are your hair wellness goals?
When did you first start experiencing changes in your hair?
What solutions are you currently using or have you tried in the past to support hair growth? (Select all that apply)
Are you experiencing any signs of menopause?
Are you on birth control?
Are you pregnant or trying to conceive?
Have you had a baby within the last year or are you currently breastfeeding?
Are you experiencing more hair shedding than usual?
Do you have trouble sleeping?
Have you experienced a major stressful event recently or within the last few years? (big move, break up, job change, surgery, family happenings, etc.)?
How often do you experience stress?
How many servings of fruit and vegetables do you consume each day?
Do you consume more than 5 alcoholic beverages per week?
Cigarette Smoking?
Are you taking any vitamins?
Any medications?
Any major surgeries?
Any known nutritional deficiencies?
Complete the form below to see results