Hair-Relaxer
First Name
First Name
Last Name
Last Name
Email
Email
Phone
Phone
Have you ever used a chemical hair straightening or relaxing product?
Yes
No
Since using the hair straightening product, have you been diagnosed with any of the following?
Uterine cancer
Endometrial cancer
Endometriosis
Uterine fibroids
Breast Cancer
Ovarian Cancer
Unsure
Not diagnosed
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Comments
Comments
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