René Furterer - Online diagnosis

In order to obtain better results, please follow all diagnosis steps:

Step 1: Maintenance

	How often in a week do you wash your hair? *

	Why? *
	putting hair back in shape (blow-drying, styling...)
	regular exercise
	pollution environment
	regular use of styling products
	wearing a helmet, hats
	frequent oiliness in hair

	Have you recently had: *
	highlights
	color-treatments
	streaks
	straightening treatments
	permanent waves
	bleaching
	nothing

* obligatory fields

Step 2: Your hair's health

	Are the roots of your hair? *

	Are your hair ends? *

	Is your scalp sensitive or irritated?
	Yes No

Do you have dandruff? *

Does it fall on the shoulders?

Yes

No

Do you experience itching?

Yes

No

Are you losing hair? *

Do you have a lot of hair falling out after bathing?

Yes

No

Are you under the impression that your hair is thinning out?

Yes

No

* obligatory fields

Step 3: Your address and phone number

	How did you find out about René Furterer? *
	through my hairstylist
	through my pharmacist
	through advertising
	through friends and family

Mr.

Mrs.

Miss

	Last Name*
	First Name
	Address*
	City*
	Postal Code*
	Country
	Date of Birth _{(Format dd/mm/yyyy)}
	Profession
	Email*

	Yes, I wish to receive by email all information about René Furterer's novelties and offers
	Yes, I wish to receive by email all information about the other Groupe Pierre Fabre brands

* obligatory fields

According to the Computer and Freedom law dating of January 6th, 1978, you have the right to access, modify, rectify or delete any personal data by simply contacting the site’s publisher at the following adress : contact@renefurterer.com

Pierre Fabre

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