New Client Questionnaire


We’re so glad you’re here. You’re in great hands!
Before we set off on your journey into whole beauty, we’d love to know a little bit about you so that we can best tailor your treatments to get the results you seek.

Our top priority is to rejuvenate your scalp and hair, and help you shine.


How would you describe the texture or overall feel of your hair? (Select all that apply)
My main hair woe is... (Select all that apply)
How do you wear your hair every day?

How often do you do the following? (No judgment, we promise.)

Shampoo and Condition
Leave-in Conditioner
At-Home Hair Mask or Leave-in Treatment
Blow Dry
Hair Straightener or Flat Iron
Professional Scalp Treatment
Hair Extensions
General stress level:No stressA little stressAverage amount of stressA lot of stressExtreme stressGeneral stress level:
How often do you exercise?
Most consistent type of exercise?
Which is your preferred scent of essential oils?
Which do you prefer?
Which of the following best describes your desired hairstyle?
Does your scalp currently have any of the following? If yes, a phone consult is REQUIRED on the Wednesday prior to your desired appointment day/time. We will call you on the number you've provided.
How did you hear about us?
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10881 W. Washington Blvd

Ste 202, Culver City, CA 90232


Thu, Fri and Sat:  9.00am - 6pm

By online appointment only