Hair extension consultation form

1
Name
First Name
Last Name
2
Email(Your email will be added to my client database occasionally you may receive email updates which you can opt out of)
example@example.com
3
Phone Number(Phone numbers are added to my client database occasionally you may receive text updates which you can opt out of)
Area Code
Phone Number
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
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The Bahamas
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The Gambia
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Guinea
Guinea-Bissau
Guyana
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India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
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Jordan
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Laos
Latvia
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Lesotho
Liberia
Libya
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Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
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Tuvalu
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Vanuatu
Vatican City
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Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
How may I contact you?Tick all that's relevant
Phone call /text
Email
Whatsapp
Social media
6
In case of emergency details-
First Name
Last Name
7
Their contact number-
Area Code
Phone Number
8
Can I take a before & after picture of your hair?I always ask before taking your picture.
Yes
No
Yes but no picture of my face please
9
Do you consent to me using the images of your hair for my social media accounts/website/Award entries & other digital platforms? Consultations may also be recorded.
YESNO
10
Hair Extension price guide

Volume fits start at around £300, Length fits start from £600.00 (for 18 inch length/mid range hair)

The hair extensions i offer include complimentary aftercare products.

Your ongoing refit appointments every 6-8 weeks will include complimentary aftercare products to ensuring you care correctly for your amazing new hair.

Free cut & finish with removal is also included should you decide or require a break from extensions.

All exact prices for hair & refitting costs are worked out at in-person consultations ,all clients will need in person consultation before i order any hair.

Hair extensions are a premium hairdressing service & require ongoing maintance - please consider this when you are working out your budget for this service.

See my booking terms for more information -https://www.rebeccabanhamhairdressing.com/skin-testing-booking-information
11
Cancellation terms-

For any service- Less than 48 hours for resheduling appointments 50% charge appointment cost.No shows 100%.

You can cancel your booking via fresha or 07900934134.

I have had a large number of no shows so have had to implement this policy.
12
Are you 18 years of age or olderI'm unable to fit extensions or provide consultations for clients under 18 years old.
Yes
No
13
What is your reason for wanting hair extensions?Tick answers that apply
Length
Boost confidence?
Thickness/ Volume
Add colour ?
14
What is your reason for wanting hair extensions.* This field is required.Example to add volume/length etc
Answer here .
15
Have you had hair extensions in the past or do you wear them now ?Please state which method below & if you liked them-
Type answer
16
If you currently wear extensions are you happy with them? Could they be improved in any way? Do you like how they are fitted etc.
Huge
Large
Normal
Small
Ok
Ok
17
Do you suffer from any mental health conditions in relation to your appearance for example depression and body dysmorphia caused by how you view your appearance?
Yes
Rather not say
No
18
Does your natural hair effect your self esteem & confidence..
Yes
Rather not say
No
19
If you answered yes or are not sure above 2 questions please explain further below.
Huge
Large
Normal
Small
Ok
Ok
20
Are you pregnant or have a child under 12 months old ?
YESNO
21
If yes to the above question would you say your hair is back normal after having your child?
Answer here
22
Are you on medication that can cause hair loss or suffer with thyroid problems ? (if unsure please consult GP)
Type answer
23
Do you have an allergy to bronze/copper?(For beaded methods I will allergy test you with some test beads)
No
Yes
Not sure
24
Do you have any known allergies?
Huge
Large
Normal
Small
Ok
Ok
25
Do you have a sensitive scalp?
YESNO
26
If yes to above please answer below.
Huge
Large
Normal
Small
Ok
Ok
27
Are you recovering from any medical condition that is connected to hair loss? (chemo therapy/alopecia)
YESNO
28
Do you have any holidays abroad planned?
YESNO
29
If yes to above- I dont recommend wearing hair extensions abroad as it reduces lifespan & accelarates colour fade.

Wearing hair extensions abroad VOIDS your manufactures warranty.
30
Do you spend time in hot tubs?
Yes
Occasionally
No
31
Do you take part in any sport activity?
YESNO
32
If yes does your sport include wearing a helmet of any kind.
33
If you wear a helmet for example for horseriding.

An adjustable riding hat will be required or you will need to be measured for a new riding hat completly.

This is to ensure no damage is caused to your natural hair.
34
Is your hair in good condition?
Yes good condition.
No needs improvement.
Not sure?
35
Your hair colour.For hair extensions to be successful they need to match your hair colour perfectly. Your regular hairdresser can do this before I colour match. Home colouring is not suitable for hair extensions. I can also colour match extensions to natural hair colours.
I need my hair colouring with you prior to extension fitting.
I have naturally coloured hair that doesn’t require colouring.
Not sure?
My current hairdresser will colour my hair.
36
Your hair colour.

I can colour match to natural hair or coloured hair.

Before your in-person consultation please make sure you are happy with your colour so i can colour match the extensions.

I can colour your hair if required hair colouring with another hairdresser whilst wearing hair extensions i have fitted is completly at your own risk.

I will take no responseability for loose extensions or hair extensions that discolour due to 3rd party colouring services

Home colouring is not suitable for whilst wearing hair extensions.
37
Are you growing your natural hair.If yes volume fits will require new hair at each refit to allow your hair to grow.
Yes
No
Not sure?
38
Do you ever wear your hair in high pony tail or high bun ?Certain methods of extensions will only allow for a low ponytail to be worn. High ponytails may only be worn max twice a week to avoid any tension occurring.
Yes
No
Sometimes
39
What products do you currently use on your hair?Type a short description of products used including product range.
40
Hair styling at home...Hair extensions require a good home styling routine-how are you at styling your natural hair?
I love styling may hair & get great results.
I'm not very good at styling my hair & find it hard work.
I have worn hair extensions before and know how to style them.
41
Do you have any questions about hair extensions or any more information that may help me with your consultation?Please type below...
Huge
Large
Normal
Small
Ok
Ok
42
Please read my aftercare guide. This guide is best viewed on a tablet or PC. Email copy auto sends after filling out this form & hard copies are available.
43
Hair rotation, each time I refit your extensions they will be fitted in a slightly different place to protect your scalp & this will enable you to wear your extensions for many months. Because of this, each time I fit your extensions they will get slightly shorter. Additional packs of hair may need to be purchased by my client to keep your hair looking as it did when I 1st fitted your hair. Hair density will also reduce as over time your extensions will become thinner than when they were 1st fitted.
I understand the above statement.
No, I don't understand the above statement.
44
Things that may stain your extensions - Smoking, tanning products, retinol & similar products may satin your extensions. The cost to rectify the hair will be met by the client in some cases new hair will need to be purchased.Do you understand the above statement?
YESNO
45
Hair extensions mask our natural hair on some clients (normally length fittings) hair around the nape may be visible when hair is greasy or kinks. For some clients, this will need straightening or tucking to hide. I will explain this fully at your consultation. Do you understand?
YESNO or unsure
46
Regrowth & refits.As hair extensions grow out, your natural can grow unevenly causing extensions particularly Ultra/pro tips can turn on their side as they grow this is completely normal. Hair that naturally sheds is trapped in the bead attachment this can look untidy as the weeks go on. Refits are usually carried out at 6- 8 weeks rarely some clients will be better on a 6-week refit due to natural hair growth. I will work with my client to find the best refit schedule.
I understand the statement
I don't understand the statement
47
Hair extension aftercare* This field is required.Please read the link below carefully on how care for your extensions - i will also explain this when you visit me - If the aftercare guide is not followed damage may occur to your natural hair & extensions.(opens new page).
48
I understand that my hair extensions will fade over time (2-12weeks) which is excluded from any warranties, recolouring costs will occur during the lifespan of your hair.
Yes I understand
No I don't understand
49
I understand that if I don't follow the aftercare advice given in my in-person consultation, damage may occur to my hair extensions & natural hair.
Yes I understand
No I don't understand
50
Please could you send me some inspo pictures of what your aspire your hair to look like. Via text/whatsapp 07900934134 or email

Hair extensions are a lifestyle choice and costly to maintain clients must listen and act on my advice for a successful fit , longevity of the extensions and to avoid damage to your natural hair.

All refits ,removals & any adjustments must be carried out by Hair Extensions by Rebecca Banham.If you visit another hair extensionist to carry these services they are soley responseable for your hair extensions & natural hair.

By signing below you agree to the above statement & the questions in this consultation form.
51
SignatureI have answered the questions truthfully & will follow any aftercare advice given.
ClearSign here.
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