What is your first name?

Enter your name.

How do you identify? info Why is this important?
The roles of male & female hormones can impact the hair and scalp in different ways. Your selection will help us customise your results.

Please select one?

What is your age?

What would you like to achieve?

You can select multiple

How would you best describe your hair?

Select those applicable to you

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You currently have…

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Where do you get your hair done?

How frequently do you get your hair cut? info If your haircut falls between months, for example, every 6 weeks, round your response up to the next marker

Every

0m
1m
2m
3m
3m+

How frequently do you...

Every dayA few times a weekOnce a weekEvery few weeksOn special occasionsNever

Use heat tools? infoEg. a blow dryer, flat iron, curling iron/wand

Use dry shampoo?

Wash your hair?

Use heat tools? infoEg. a blow dryer, flat iron, curling iron/wand

Use dry shampoo?

Wash your hair?

How often do you eat…

Every dayMost DaysOnce a weekRarely

vegetables and fruits 3 serves of vegetables and 1 serve of fruit

protein Protein infoEg. meat, chicken, fish/seafood, tofu, legumes/beans, eggs, nuts/seeds, dairy

good oils Good oils? infoE.g. nuts, seeds, avocados and coconut oil

eat out Fast food or eat out?

vegetables and fruits 3 serves of vegetables and 1 serve of fruit

protein Protein infoEg. meat, chicken, fish/seafood, tofu, legumes/beans, eggs, nuts/seeds, dairy

good oils Good oils? infoE.g. nuts, seeds, avocados and coconut oil

eat out Fast food or eat out?

How would you rank your stress levels?

No Stress
Occasional stress
Chronic stress

Are you...

vegan/vegetarian vegan/vegetarian?

medications currently taking any medications?

supplements currently using any supplements?

pregnant pregnant or breastfeeding?

Have you had surgery within the last 6 months?

Thank you for completing Apotecari's My Hair Analysis

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