Extension Consultation Form

Extension Consultation Form

You will be contacted within 72 hours via email to discuss this questionnaire
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How did you find out about us?*
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*

YesNo
Please check off any conditions/contradictions that apply to you:*

Thinning HairBaldingOCDTrichotillomaniaSensitive ScalpCancerChemotherapyThyroid ConditionBack/Neck PainLight SensitivityAnxiety/Panic AttacksSeizuresNone
Have you been pregnant within the last 4 months?*

YesNo
Please list any medications you are currently taking:*
Please check all that apply to your lifestyle:*

Active lifestyleFrequent swimmerFrequent hot-tub userWears hair up in high bun/pony tail oftenGoes to bed with wet hairNone
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?*

LengthVolumeBoth
Please upload 1-3 inspiration photos*

Cancelof
Please upload photos of your current natural hair: front, back, and sides in natural lighting*

Cancelof
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 acknowledgeI do not acknowledge
Should be Empty: