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amy walsh
amy walsh
Phone Number
Email
Age
Occupation
General health
Health Changes
Procedures in the last 12 months
Family medical history
Medication/Supplements
Products / Routine
How often do they wash their hair?
Reaction to any brands
Description of situation
Main Concern
Appearance/Symptoms
First noticed
Ever been diagnosed with a scalp condition?
If yes please specify
Do they have colour in their hair?
Have they ever been pregnant?
If yes, how long ago?
Allergies
If yes then please specify
What is their current diet like?
How did they hear about us?
Imagery
Front facing
Left side
Right side
Area of concern