Name *

名

姓

Email *

Mobile *

Have you had allergic reactions to any plants ? *

• Yes
• No

Roughly how long have you had oily scalp? *

Do you use any scalp/hair products apart from shampoo and conditioner ? If so please tell us what they are. (ie. dry shampoo / leave on conditioner / hair growth products / styling products)

Will you tell us the reason why you would like to try this oily scalp mask ?

Please list your preferred day & time (ie. Tuesday after 2pm) *

I acknowledge and understand that this treatment is not a medical treatment and I give my feedback and permission for publishing my scalp photos on K's own media. *

• Yes
• No

Submit