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Thank
you for your interest in EcoColors Haircolor.
In order to help you pick a color, please answer the following
questions:
This information is confidential
Do
you currently have color on your hair?
Yes
No
If
yes, what brand, and shade are you using?
What
is your percentage of gray?
%
What
is your natural color?
What color was your hair as a child?
What
color would you like your hair to be?
Do
you mind some red tones in your hair or would you like
to discourage red tones?
Some red tones
Discourage red tones
Have
you had a reaction to the brand you are currently using?
yes
no
If
yes, please describe your symptoms.
How
long have you been using your current haircolor shade and
brand?
For
statistical purposes please answer the following questions:
What
is your age?
How
long have you been coloring your hair?
Have
you always used the same brand and shade? Please explain
in detail.
Do
you smoke?
yes
no
used to
Are
you on any medications?
yes
no
If
yes, what are the name of the medications?
Have
you had surgery in the past three years?
yes
no
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