Your Hair Story

Please fill out this form to the best of your ability. The more information you provide us with, the more we are able to help address your goals and needs.

Your Hair Story

  • General Information

  • Please select one
  • Date Format: MM slash DD slash YYYY
  • Please check all that apply.
  • Your Health

  • List any and all medications
  • Food, medication, color, other. Please list NONE if you have no allergies.
  • Please list type
  • Your Scalp

    Please select all that apply.
  • Date Format: MM slash DD slash YYYY
  • Your Hair History

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
    Such as a perm, relaxer, or keratin treatment
  • Please line up ALL your hair products and take a picture of them as a group.
    Accepted file types: jpg, png, gif.
  • Pictures of your hair and your current products will help us make your consultation as productive and helpful as possible. Please upload the necessary pictures below:
  • Please upload a front-facing picture from your collarbone up.
    Accepted file types: jpg, png, gif, jpeg.
  • Please upload a side-facing picture for one side of your head.
    Accepted file types: jpg, png, gif, jpeg.
  • Please upload a side-facing picture of the other side of your head.
    Accepted file types: jpg, png, gif, jpeg.
  • Please upload a picture of the back of your head.
    Accepted file types: jpg, png, gif, jpeg.