Program for Scalp Care
Program for Scalp Care
Includes a customized program for scalp care written by the Hair Dr. and also Lisa Akbari's Hair Nutrition System which includes a one month supply of three care products: 1) Cleansing, Clarifying, and Balance Shampoo; 2) Deep Penetrating, Protein Moisture and Stabilizing Conditioner; 3) Hair Vitamins Leave-in Conditioner and support products which includes: Oil Sheen in a Jar, Moisture Plus Moisturizer. Scalp Treatment #1 and Scalp Treatment #2 Lisa Akbari Hair Products and Programs CUT AND PASTE AND e-mail to lisa@lisaakbari once you pay for your order PLEASE FILL OUT> Lisa Akbari Hair and Scalp Questionnaire Sending a photo will help. Contact Information Name: ________________ E-mail ________ Phone number: _cell _________ #2 number _________ Questionnaire: Hair Is your hair Natural ____ Do you have chemicals in your hair? _____ Does your hair feel dry? ______ Does your hair look dry? ____ How to you wear your hair:
Questionnaire: Scalp Does your scalp itch? Yes __ No __ Does your scalp feel tender and sore? Yes __ No __ Does your scalp burn? Does your scalp have bumps? Yes___ No____ Does your scalp have bald spots or short broken areas? _____ Bald Spots Any Bald Spots: ____ Location of any bald spots: ______________________ How long have you had balding? ______________________________ How often do you Shampoo your hair: _____How often ______ Do you Condition your hair: ___ How often ____ Do you use leave-in conditioner, if so how often?: _______ Describe your hair regimen: Other issues or challenges/ Tell us your hair story: ______________________________ ______________________________ ______________________________
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