Extension Request Form

Extension Request Form:
Name*

FirstLast
Phone Number*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
What day/time works best for your appointments? (select ALL that apply)*

Monday 10am-12pmMonday 12pm-4pmTuesday 2pm-5pmTuesday 5pm-8pmFriday 10am-12pmFriday 12pm-4pm
Length of your natural hair*
Select Your Hair Density:*
What is your natural hair texture?*
Do you have any current damage?*
Current hair color services you receive*
Ex: Root retouch, hilights, lowlights, all natural
Are you wanting to keep or change up your hair color?*
Take a photo of the front of your hair- smile pretty :)*
Side of your hair *
Back of your hair *
Have you ever worn extensions before?*
If yes, which method have you worn & what did you like/not like about it? *
You are wanting extension hair to add:*
Describe your desired result after your extensions are installed (length, color, etc):*
List products that you currently use on your hair:*
Ex: shampoo, conditioner, styling products
How often do you shampoo?*
Do you have any medical history that has directly affected your hair or scalp?*
Ex: Thyroid, cancer, eczema, etc
How did you hear about me?*
Ex: referral, social media
I will be in contact with you soon to meet your hair needs!

Check your inbox for RSbyJamie@gmail.com
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Extension Request Form: