The Hair Health Assessment Form was created to learn about the history of your hair and it's current health to achieve your desired goals. Only fill out the Hair Health Assessment Form if you have an upcoming hair appointment, requesting a phone consultation, or it's been greater than 90 days since your last appointment! Thank you!

Hair Health Assessment
What is your age?
Overall Hair Health
Are you currently experiencing hair loss/breakage?
When was your last cut/trim?
If you are Natural, what is your curl pattern?
Is your hair chemically treated/treated by any of the following?
Are you currently transitioning?
What is your Hair Porosity?
Your hair is...
Your scalp is...
CHECK ALL THAT APPLY: Are you taking any of the following medications?
CHECK ALL THAT APPLY: How Do You Normally Wear Your Hair?
Are you in search of a long term Hairstylist?
Share a picture of the back of your hair... 
Upload File
How did you hear about me?

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