XPOH2O Maximum Hydration Consultation Form

First name

Last name

Email

Phone

What is your current hair care regime?

What are the home care products you use?

Tell me about your hair history?

Chemical History?

What is your hair goal and ideal natural hair experience?

Do you generally go to a professional for hair services?

Yes

No

Sometimes/Rarely

What is your hair care maintenance and daily styling routine?

How often do you shampoo?

Do you do "No Poo" or Co-Washing?

I do No Poo

I Co-Wash

None

What detangling tools or products are you currently using?

Are you using any heat application such as flat iron, hot combs, blow-dryers?

Flat Iron

Hot Comb

Blow Dryer

Other

How would you describe the density of your hair?

Describe your length?

Scalp condition, dry, itchy, flaky, normal, oily or tender?

How would you describe the condition of your natural hear?

Describe your natural hair texture:

Wavy

Loose Curls

Medium Curls

Coily/Tight Textured

How often do you have your hair trimmed, when was your last trim?

Are you transitioning?

Yes

No

Do you wear protective styles?

Yes

No

What is your lifestyle? (e.g. a student, professional, gym, swim, outdoors, or artist)

This will be more than a service, this is a personalized educational experience where you will learn hydration techniques. Please share anything else that we should know.