DUPÏ™ Name * First Name Last Name Email * Phone (###) ### #### What type of Hair & Scalp do you have? * Please describe it as detailed as possible: Oily, Dry Ends, Dry Scalp, Color-treated hair, Curly, Wavy, Straight, Fine, Thick, Coarse, Long, Short, Buzzcut, Voluminous, Flat, Dull ,Bouncy.. What is your budget for scalp care/hairloss? * $10-20 $20-30 $35-60 It wouldn't matter as long as I knew it was effective Survey * I have to wash my hair everyday Strongly Disagree Disagree Neutral Agree Strongly Agree I wash my hair 2-3x a week Strongly Disagree Disagree Neutral Agree Strongly Agree I would receive regular scalp care treatments (if available nearby) Strongly Disagree Disagree Neutral Agree Strongly Agree I do scalp masks pre-wash Strongly Disagree Disagree Neutral Agree Strongly Agree I apply scalp serums regularly Strongly Disagree Disagree Neutral Agree Strongly Agree I take supplements regularly for hair growth (biotin, collagen, etc) Strongly Disagree Disagree Neutral Agree Strongly Agree I believe scalp health is related to my circulation Strongly Disagree Disagree Neutral Agree Strongly Agree What kind of results would you like to see in 3-4 weeks with Dupi to feel satisfied with the product? * Please check below if you can provide us pictures with your scalp/hair progress every week for the next 4-6 weeks. * We will be tracking everyone's results! This focus group is for our new scalp care line that is rooted in aiding circulation and its main ingredient is rooted in natural/organic minerals from S.Korea. It is patented technology & FDA approved. I can meet Dupi's requirements I cannot be a part of this focus group Thank you so much for filling out our form. If you qualify for our Focus Group, I will confirm via email and collect your address to send you a sample product.
