Extension Consultation Form
You will be contacted within 72 hours via email to discuss this questionnaire
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How did you find out about us?
*
Please Select
Instagram
Facebook
Google
Website
Referral
Other
Have you worn extensions before? If so please indicate which method(s) and what you liked/disliked about each
*
Do you currently have hair extensions in? **Note: You need to be extension free for your consultation
*
Yes
No
Please check off any conditions/contradictions that apply to you:
*
Thinning Hair
Balding
OCD
Trichotillomania
Sensitive Scalp
Cancer
Chemotherapy
Thyroid Condition
Back/Neck Pain
Light Sensitivity
Anxiety/Panic Attacks
Seizures
None
Have you been pregnant within the last 4 months?
*
Yes
No
Please list any medications you are currently taking:
*
Please check all that apply to your lifestyle:
*
Active lifestyle
Frequent swimmer
Frequent hot-tub user
Wears hair up in high bun/pony tail often
Goes to bed with wet hair
None
How often do you wash your hair?
*
What is your current hair care routine?
*
How often to you use heat on your hair? Do you use a heat protectant?
*
Are your goals to achieve length, volume, or both with extensions?
*
Length
Volume
Both
Please upload 1-3 inspiration photos
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload photos of your current natural hair: front, back, and sides in natural lighting
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I acknowledge and understand Elevation Hair Lounge's cancellation policy: If you fail to provide a minimum of 48 hours notice to cancel your appointment you will be charged 50% of your service fee (consultation deposit will become void). If you are a no show or cancel the day of, you will be charged 100% of your service fee (consultation deposit will become void). If you are more than 15 minutes late to your appointment it will automatically be cancelled and you will be charged 100% of your service fee.
*
I acknowledge
I do not acknowledge
Submit
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