Hair Extensions Consultation Form
Name
*
First Name
Last Name
Email
*
example@example.com
Contact Number
*
-
Area Code
Phone Number
What is your reason for wanting hair extensions?
*
e.g. length, thickness or to add colour
Have you had hair extensions before, if, so, which method?
If you currently wear hair extensions, are you happy with them? Could they be improved in any way?
Have you ever suffered with hair loss?
*
Yes
No
Have you ever been diagnosed with alopecia or any other hair loss related illnesses?
*
Yes
No
Are you currently on any medication that can cause hair loss or thinning?
*
Yes
No
Do you suffer from scalp eczema/psoriasis
*
Yes
No
Would you consider your scalp to be sensitive?
*
Yes
No
Do you have any known allergies?
*
Yes
No
Do you have metal sensitivity?
*
Yes
No
Do you swim or exercise regularly?
*
Yes
No
Do you use saunas, steam rooms or sunbeds?
*
Yes
No
I can confirm that the information I have given is accurate and I will not hold the salon/stylist responsible for any damages caused by having supplied incorrect information.
*
Yes
I understand I am paying for a product and not a service so therefore this is non-refundable.
*
Yes
I understand that hair extensions are a perishable product and therefore the longevity and continued quality cannot be guaranteed. To increase the longevity of my extensions I understand I must follow aftercare advice given.
*
Yes
Signature
*
Submit
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