Hair Extension Consultation Form
I am excited for you to take your first step towards achieving your dream hair. Please be advised that hair extensions are not an option for everyone. My job as a professional is to offer you the method that will allow your natural hair to stay healthy and in the best condition possible. This consultation is a preliminary screening process to see what extension method is best for you and your lifestyle. Clients will need to come in for a person to person consultation for accurate color and texture matching, questions concerns, maintenance, pricing and information on how to take care of your new investment.
Name
*
First Name
Last Name
Preferred Pronouns
Please Select
She/Her
He/ Him
They
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Is this your 1st time with hair extensions?
*
Yes
No
If no, What type of hair extensions have you had in the past? What was your experience?
*
What type of extensions are you interested in?
*
Keratin-Tips
Cylinder/ I-Tips
Tape-Ins
MicroLink Wefts
Micro Bead (Hand Tied, Braidless Sew-In)
MicroLoops
V Light
Will you be needing to refresh your natural color to match your extensions?
*
Yes
No
Are you experiencing any of the following scalp or hair issues (click all that apply)
*
Thinning or Balding
Dry Hair/Scalp
Oily Hair/Scalp
Hair Breakage - mid shaft to ends
Hair Shedding (white bulbs on tips of hair)
Damage due to Chemical/Heat/Hormones
Dandruff/Flaky Scalp
Receding Hairline
How would you describe your hair? (click all that apply)
*
Thick
Fine
Average
Damaged
Coarse
Wavy
Straight
Curly
Thin
Frizzy
Other
Are you taking medication that lists hair loss as a side effect?
*
Yes
No
Are you applying anything topical or taking anything to help with hair loss or scalp problems?
*
Yes
No
Have you over the past year experience any health changes that result in hair loss? (Pregnancy, Chemotherapy, Iron Deficiency, Alopecia, Covid)
*
Yes
No
How did you hear about me?
*
Instagram
Yelp
Google Search
Facebook
Referral
Are you ok with before and after photos being taken for social media?
Yes
Yes, but not my face
No
Submit
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