Halo Revival Form

1

Name* This field is required.

first name

last name

2

Pronouns* This field is required.

3

Phone* This field is required.

4

E-mail* This field is required.

example@example.com

5

Did you purchase your Halo Couture extensions from GEMPIRE HHC?* This field is required.

YESNO

6

If you did not purchase your extensions from GEMPIRE HHC, where did you purchase the extensions?

7

How long have you had your Halo, Fall, or Ponytail?* This field is required.

8

What length are the extensions?* This field is required.

9

How have your extensions been washed and cared for previously?* This field is required.

I washed them at home

A professional washed them

I've never washed them

10

Please elaborate on whether or not your extensions need coloring service and what color changes you are interested in.* This field is required.

11

Please upload recent photos of your Halo, Fall, or Ponytail (front and back)* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB