Customer intake form

Company Name

Company Contact*

Email*

Phone Number*

Do You Own An Existing Formula? YES or NO*

If yes, please specify product description and skip to "Additional Information", if no, complete entire form

Give a summary of your project/idea

Specify formulate style (hair care, skin care, natural products, organic products, etc.)

Specify formulate type (moisturizer, toner, shampoo, leave-ins, etc.)

Please specify any "no-no" chemicals or ingredients (ingredients you DO NOT want used in the formulation)

Please specify key ingredients (i.e. ingredients you want included in the formulation)

Additional Information: What is your timeline? (projects must add 12 weeks to timeline after the last sample is approved by customer)

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