Name
*
First Name
Last Name
Instagram Handle
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
How did you hear about me?
*
Have you had any type of extensions before?
*
Yes
No
Are you currently wearing extensions?
*
Yes
No
How long have you been wearing extensions?
*
0-6 Months
6-12 Months
12-18 Months
18 Months+
Do you have any type of medical condition that causes hair loss as a side effect?
*
Yes
No
Do you currently/have you ever received chemotherapy treatment?
*
Yes
No
Have you had COVID-19 in the past 6 months?
*
Yes
No
How long is your natural hair?
*
Above Shoulders
At Shoulders
Below Shoulders
My hair is:
*
Fine
Medium
Thick
My texture is:
*
Straight
Wavy
Curly
What is the current condition of your hair? (1 being extremely damaged, 10 being in perfect condition)
*
1
2
3
4
5
6
7
8
9
10
Worst
Best
1 is Worst, 10 is Best
Is your hair colored or chemically treated in any way?
*
Yes
No
Why do you want to get extensions?
*
Volume
Length
Both
Other
Please include a photo of the front of your hair:
*
Browse Files
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of
Please include a photo of the side of your hair:
*
Browse Files
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of
Please include inspo pictures:
*
Browse Files
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of
Additional questions or comments:
Signature-I have reviewed all salon policies:
*
Submit
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