FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

Have you personally used any type of haircolor product, including permanent, non-permanent, temporary, bleaches, highlighting, sprays, root products, product at home, or in a salon, in the past 6 months?

Yes
No

Where do you color your hair?

At home only
Both at home and a salon
At a salon only
Never colored my hair before

How frequently do you color your hair?

Every 4 weeks or more frequently
Every 1 – 3 months
Every 3 - 6 months
Every 6 -12 months
Less often than Every 12 months

When was the last time you colored your hair?

Within the last 4 weeks
Within the last 1-3 months
Within the last 3-6 months
Over 6 months ago
Never colored my hair before

What shade is your natural (not dye) color closest to?

What shade is the last color you used on your hair?

Light Blonde
Light Ash Blonde
Medium Golden Blonde
Medium Blonde
Medium Ash Blonde
Dark Blonde
Light Brown
Light Golden Brown
Medium Brown
Medium Golden Brown
Medium Auburn
Dark Brown
Black
Other

If you didn't use a hair color at all, what would be the amount of gray in your hair?

I have no gray hair
About a quarter of my hair is gray
Less than half of my hair is gray
About half of my hair is gray
More than half of my hair is gray
All of my hair is gray
I do not know

Into which of the following categories does your age fall?

Under 18
18 - 34
35 – 44
45 - 55
Over 55

In just the past 2 years, what are all the brands of hair color that you, yourself, have used when coloring your hair at home?

Clairol Nice 'n Easy
Clairol Natural Instincts
Clairol Nice 'n Easy Root-Touch-Up
Garnier Nutrisse
Garnier Olia
L'Oreal Excellence
L'Oreal Feria
L'Oreal Preference
Revlon ColorSilk
Highlighting Product
Non-Permanent hair color
Other Brand
Never colored my hair before

10. What was the Brand and Shade did you, yourself, use last to color your hair at home?

Regarding the brand listed above, would you say that you use this product:

Exclusively
Most frequently
About half the time
I switch back and forth with the others

Which of the following best describes the length of your hair?

Close cut (i.e. very short, Pixie, Boy Cut, etc.)
Ear/chin length
Between ear and shoulder length
Longer than shoulder to mid-back
Longer than shoulder to mid-back
Longer than mid back

Thinking about when you color your hair all-over AT HOME, which phrase below best describes how you apply the hair colorant?

I only apply hair color to my roots
I apply hair color to the roots first and once they are covered I immediately apply color to the rest of my hair
I apply hair color to the roots first and then wait some time before I apply color to the rest of my hair (I actually put the hair color product down after covering the roots and wait a specific length of time before I apply color to the rest of my hair
I apply the hair color all over, all at once without paying any kind of special attention to the roots
I apply hair color some other way

Which of the following best describes your ethnic background or the ethnic backgroup that you most identify with?

Hispanic/Latino
African American
Caucasian
Native American
Asian
Bi-racial
Other

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