• HAIR
  • SCALP
  • HORMONES AND GENETICS
  • LIFESTYLE

Welcome to your Hair Assessment

To better understand and evaluate your unique situation, let’s spend the next 5 minutes going through some questions regarding your hair, scalp, health, and lifestyle.

Now let’s get started!

First things first…

Please insert valid first name Help text!
Please insert valid last name
Please insert valid e-mail
Please insert valid phone number

Email has been sent to EMAIL with a link to where you left off

Back

What type of products are you interested in?

Men’s Women’s
Back

What is your age range?

<20
20-29
30-39
40-49
50-59
60+
20-29
40-49
60+
<20
30-39
50-59
Back

Why do we ask: Your age range helps us determine the best regimen for you!

What are your hair goals?

Please select up to 3 goals
Back
Remember to select an answear

Why do we ask: So we can recommend the best products to help reach your goals!

What is your natural hair type?

hair-straight Straight
hair-straight-Men Straight
hair-wavy Wavy
hair-wavy-Men Wavy
hair-curly Curly
hair-curly-Men Curly
hair-kinky Coily
hair-kinky-Men Coily
Back

Why do we ask: We help people with all different kinds of hair types - let us know yours so we can recommend the right products for you!

How would you describe your hair?

Thin Average Thick
Back

Why do we ask: This helps us understand how you experience your hair and how we might help!

Which of these illustrations best match how much scalp you see when observing your hair?

savin01
savin02
savin03
savin04
savin05
savin06
savin07
savin01M
savin02M
savin03M
savin04M
savin05M
savin06M
savin07M
Back

Why do we ask: This gives us a better idea of the health of your follicles and helps us determine if our Extract program would be a valuable fit for you!

How happy are you with your hair today?

Very happy Quite happy Could be happier Not happy Seriously unhappy
Back

Why do we ask: Yes, we will ask you this question again in the future! Our aim is to make you happier than you are now.

Have you noticed any of these changes in your hair?

Select all that apply.
Back
Remember to select an answear

Why do we ask: These are common symptoms of thinning hair that we might be able to help improve!

When did you first notice these changes?

0 - 6 Mo
6 Mo - 2 Yrs
2 - 5 Yrs
5 - 10 Yrs
10+ Yrs
6 Mo - 2 Yrs
5 - 10 Yrs
0 - 6 Mo
2 - 5 Yrs
10+ Yrs
Back

Why do we ask: We hope this prompts you to stop and think back to when you remember your hair being at its best. It’s often longer than we realize!

Is your hair color-treated or chemically processed at the moment?

Yes No
Back

Why do we ask: This helps us customize the best hair care regimen to look after your hair strands!

Do you ever use any of the following products?

Select all that apply.
Back
Remember to select an answear

Why do we ask: We can recommend healthy and nourishing alternatives based on your needs!

Do you actively try to avoid any of these ingredients?

Select all that apply.
Back
Remember to select an answear

Why do we ask: Our entire regimen is made of pure, safe and healthy constituents, so whether you’re ingredient-conscious or not, you can feel good about what you’re putting on your hair and scalp!

How often do you feel that your scalp is dry, itchy, or tight?

Never Rarely Often Always
Back

Why do we ask: A healthy scalp promotes healthy hair so we need to understand your scalp environment to address any imbalance!

Do you sometimes notice dandruff, white, or yellow flakes in your hair or on your shoulders?

Never Rarely Often Always
Back

Why do we ask: A happy scalp equals beautiful hair. If you do notice that your scalp is flaking, this might be a sign that your scalp environment is out of balance!

Have you recently noticed any severe redness or severe irritation on your scalp?

Yes No
Back

Why do we ask: This helps us determine the right time to recommend our Extract program!

How often do you shampoo per week?

Daily
Every 2nd day
Twice
Once or less
Every 2nd day
Once or less
Daily
Twice
Back

Why do we ask: This can give us insight into the general condition of your scalp and your mindset around shampooing! (Fun fact: We are big advocates of frequent shampooing to keep the scalp clean + healthy!)

How long does it usually take before your hair gets oily after you wash it?

Same day
Next day
Two days after
Three days after
Unsure
Next day
Three days after
Same day
Two days after
Unsure
Back

Why do we ask: Excessive oil producution can contribute to hair thinning so we want to understand your unique situation!

Are you pregnant or have given birth within the last 6 months?

Yes No

Good to know!

Please enter the date of birth or expected due date

Back

Why do we ask: This helps us determine if our Extract program might be right for you!

Good to know!

Please enter the date of birth or expected due date

Invalid input! Please insert date in format mm-yyyy Help text!
Back

Have you ever had a hair transplant?

Yes No
Back

Why do we ask: This helps us determine if our Extract program might be right for you!

Have you had one or more hair transplants within the last 6 months?

Yes No
Back

Why do we ask: This helps us determine if our Extract program might be right for you!

Have you used any products for hair thinning or hair loss within the last 6 months?

Yes No
Back

Why do we ask: This could be products like Rogaine, Propecia, PRP, or the like

Have you had surgery under general anesthesia within the last 4 months?

Yes No
Back

Why do we ask: This helps us determine the right time to recommend our Extract program!

Have you ever been diagnosed with an autoimmune type of Alopecia?

Yes No
Back

Why do we ask: This helps us determine if the Extract program is right for you!

What was your diagnosis?

Totalis Universalis Frontal fibrosing Lichen planopilaris Areata
Back

Why do we ask: This helps us determine if the Extract program is right for you!

How common is hair thinning or hair loss in your family?

Very common Somewhat common Not very common Unsure
Back

Why do we ask: Hereditary hair thinning (a.k.a., androgenetic alopecia) might run in your genes. The prevalence in your family gives us insight into your unique situation!

How much hair shedding are you currently experiencing?

Nothing A little bit Quite a lot Extreme amounts
Back

Why do we ask: Everyone has their own ’’normal’’ and occassional increased shedding can also be normal. We want to understand what you’re experiencing now so we can factor that into our recommendations!

Have you been diagnosed with telogen effluvium within the last 6 months?

Yes No
Back

Why do we ask: There is an important difference between hair shedding and hair thinning/loss. Occasional shedding is completely normal, so don’t worry if you experience slightly increased shedding every once in a while.

Did you start or discontinue any medication that could cause hormonal changes within the last 6 months?

Yes No
Back

Why do we ask: This gives us insight into potential systemic factors and heps us determine the right time to recommend our Extract program!

Are you currently undergoing (or have in the last 6 months) radiation, chemotherapy and /or immunotherapy?

Yes No
Back

Why do we ask: This helps us determine when and if the Extract program is right for you!

How would you rate your overall stress right now?

Not feeling stressed Moderately stressed Highly stressed Exceptionally stressed
Back

Why do we ask: We take a holistic approach to your hair health so understaning your stress level is important in helping us help you!

How stressed have you felt over the past 6 months?

Not feeling stressed Moderately stressed Highly stressed Exceptionally stressed
Back

Why do we ask: Both accute and prolonged stress can upset your hormonal balance and lead to a variety of hair concerns. Addressing those concerns from a holistic standpoint helps us optimize your hair!

Have you experienced very stressful events within the past 6 months, e.g. a divorce, moving house, jobs, or similar?

Yes No
Back

Why do we ask: Accute stress can offset hormonal balance and trigger shedding or even hair thinning, so understanding high stress events helps guide our recommendations for you!

How often do you set aside time to relax and de-stress? 

Every day
Once per week
Once per month
Rarely
Once per week
Rarely
Every day
Once per month
Back

Why do we ask: Regularly unplugging from stress and practicing self-care can benefit your mind, body AND hair!

How often do you work out?

Daily
A few times per week
A few times per month
Rarely
A few times per week
Rarely
Daily
A few times per month
Back

Why do we ask: Developing healthy lifestyle habits can help your hair stay in great shape, too!

How many hours of sleep do you typically get per night?

More than 8 hours Between 6-8 hours Between 4-6 hours Less than 4 hours
Back

Why do we ask: Sleep is our body’s way of recalibrating, detoxing and helping to keep the hormones balanced. Understanding your sleep habits gives us an idea of how much this factors into your hair health!

Do you usually feel well rested when you wake up in the morning?

Yes No
Back

Why do we ask: This helps us understand how well your body and hormones are recovering during sleep!

Which best describes your normal diet?

Unhealthy Balanced Vegan Ketogenic
Back

Why do we ask: The foods we eat (or don’t eat) heavily influence our hair health, so we want to understand what you are feeding your follicles!

Do you smoke cigarettes?

Yes No
Back

Why do we ask: We approach hair health from a holistic standpoint, so it’s helpful to know the variables involved in your overall health!