Name *

First Name

Last Name

Phone *

(###)

###

####

Do you currently experience any of the following issues with your scalp? (Check all that apply)

Itching or discomfort

Dry, flaky skin

Excess oiliness

Product build-up

Sensitivity or irritation

Hair thinning or shedding

Other (please specify)

How often do you wash your hair?

Daily

2-3 times a week

Once a week

Less than once a week

Have you previously had any professional scalp treatments?

Yes

No

Do you have any known allergies or sensitivities to hair or scalp products?

Yes

No

Are you currently taking any medications or undergoing any treatments that might affect your scalp or hair?

Yes

No

What are your main goals for the scalp wellness check? (Check all that apply)

Reducing dandruff

Improving scalp hydration

Managing oiliness

Enhancing hair growth

Soothing scalp sensitivity

What to Expect from Your Ultimate Scalp Detox: *

Your appointment will include a detailed scalp analysis with before and after pictures, a customised treatment tailored to your needs, infrared therapy to stimulate hair follicles, a relaxing steam session to open pores, heated eye mask and a soothing scalp massage. The service concludes with a professional blow-dry for a polished finish. Duration: 1 hour Price: £60 Get ready for a relaxing and revitalising experience that promotes healthier hair and scalp!

Great Thanks.