Hair Questionnaire

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What's Your FIRST Name?* This field is required.
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Nice to meet you, {fname}!

We are super excited to hear about YOUR Specific Hair Goals, and WHY You Want to Experience Our Luxury Hair Services.

That's why we have a couple of quick questions for you to help us assess the current state of your hair, which ultimately helps us provide you with the best recomendation that will suit YOUR Specific Hair Goals and Needs.
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How Did You Hear About Us?
Internet Search
Friend / Referral
Instagram
Facebook
Other
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What Hair Service Are You Primarily Interested In Receiving a Consultation For Today?* This field is required.Please select one of the following services.
Hair Extension Services
Luxury Color Services
I Want It All (Both Extensions and Color)
Keratin Smoothening Hair Treatment
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Choose Which Best Describes Your Hair Currently* This field is required.
I'm experiencing noticeable hair loss with visible scalp areas and am seeking a solution.I'm not experiencing significant hair loss, but I'm unhappy with the length or thickness of my hair.
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When Did You First Notice Hair Loss?* This field is required.
Recently (1-2 months)
3-6 Months Ago
6-12 Months Ago
Over a Year Ago
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Have You Been Diagnosed With a Specific Hair Condition?* This field is required.
YESNO
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What Treatments, if Any, Have You Tried For Your Hair Loss?* This field is required.Please List Treatments below. If no treatments, write "NONE"
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Small
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Ok
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Are There Any Lifestyle Factors (e.g., diet, stress, hair care routine) That May Be Affecting Your Hair Health?
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Ok
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Are You Currently Taking Any Medications or Supplements?* This field is required.
YESNO
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Are You Currently Wearing Hair Extensions?* This field is required.
YESNO
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How Long Have You Been Wearing Hair Extensions?* This field is required.
0-3 Months
4-12 Months
1-3 Years
4-6 Years
7-10 Years
10+ Years
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Have You Had Hair Extensions in the Past?* This field is required.
YESNO
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What Hair Extension Methods Have You Had, And What Has Been Your Experience With Them?* This field is required.
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Ok
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{fname}, What is it about Hair Extensions That Has You Ready For A Consultation? - And Why Now?* This field is required.This is a chance for you to tell me a little more about The WHY behind your desire to sit in my chair, so take a few moments to think through and complete this question.
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Have You Had a Keratin Treatment or Smoothening Treatment in the Past?
YESNO
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Which Of The Following Describes The Texture of Your Hair?* This field is required.
Fine / Thin
Medium / Average
Fine, but plenty of it
Coarse / Thick
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Which Of The Following Describes The Amount Of Hair You Have?* This field is required.
Very little amount of hair.
Medium amount of hair.
Thick
Super Thick
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Is Your Hair Shoulder Length Or Longer?* This field is required.
YESNO
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Do You Color Your Hair?* This field is required.
YESNO
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Is Your Hair Blonde or Gray?
YESNO
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How Long Do You Want the Smoothing Treatment to Last?
Up to 3 Months
Up to 5 Months
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Are You Happy With Your Current Color?
YESNO
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Are You Looking To Change Or Update Your Current Color, Or Stay With What You Have Today?* This field is required.
Change And Update
Stay with what I have, with minor adjustments
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Ok {fname}, In Which Direction Would You Like To Go?* This field is required.
Lighter
Darker
More Dimension
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Which Best Describes Your Hair's Condition?* This field is required.
Healthy Overall
Healthy, But I Have Signs Of Dryness On The Ends
Slightly Compromised, Damaged From A Past Hair Situation
Over Processed / Broken
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Do Have Any Known Allergies (Especially Related to Hair Products / Materials) ?* This field is required.
YESNO
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Please List Known Allergies* This field is required.
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Small
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Ok
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What Concerns or Questions Do You Have About Using Hair Extensions as a Solution?
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Ok
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What is Your Desired Outcome You Wish to Achieve From the Use of Hair Extensions?* This field is required.
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How Tall Are You?This helps us determine the length of hair extensions needed to meet your desired outcome.
Feet
Inches
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Do You Have A Preferred Stylist You Are Interested In?* This field is required.
First Available
Aurora
Elise
Stephanie
Mindy
Claire
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Show Me Your Current Hair

Follow the instructions below and upload photos of your current hair on the next steps.

This is the final stage of the application and the most important.

Must be photos of your current hair.

Use your cell phone.

For best results, have someone else take the photo for you (No Selfies)

Take indoors in natural lighting (No Flashes or Direct Sunlight)

You will take two photos - Front and Back.

Please attach at least 2 Inspirational Photos. (Images of the result you are looking to achieve)

*If you are experienceing hair loss or thinning in a specific area please upload clear photo of that area of concern.

Here are examples of a Front and Back Photo:

Here are Two Examples of Inspirational Photos Showing Color and Style:

Click the Next Button when your ready to upload your photos.
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Choose how you want to submit your photos.* This field is required.Your Photos are private and confidential. They will not be shared with anyone but your assigned consultation stylist.
Take my front and back photos for meI have my front and back photos ready to upload
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Upload Your Front Photo* This field is required.Must be photos of your current hair. Use your cell phone. For best results, have someone else take the photo for you (No Selfies) Take indoors in natural lighting (No Flashes or Direct Sunlight)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Upload Your Back Photo* This field is required.Must be photos of your current hair. Use your cell phone. For best results, have someone else take the photo for you (No Selfies) Take indoors in natural lighting (No Flashes or Direct Sunlight)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Take Your FRONT Photo* This field is required.Must be photos of your current hair. Use your cell phone. For best results, have someone else take the photo for you (No Selfies) Take indoors in natural lighting (No Flashes or Direct Sunlight)
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Take Your BACK Photo* This field is required.Must be photos of your current hair. Use your cell phone. For best results, have someone else take the photo for you (No Selfies) Take indoors in natural lighting (No Flashes or Direct Sunlight)
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Upload Your Desired Look / Inspirational Photo 1:* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Upload Your Desired Look / Inspirational Photo 2:* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Upload Your Desired Look / Inspirational Photo 3:Optional
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Upload Your Desired Look / Inspirational Photo 4:Optional
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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What's Your LAST Name?* This field is required.
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What's Your Phone Number?* This field is required.
Please enter a valid phone number.
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What's Your Best Email Address ?* This field is required.
example@example.com
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PLEASE BE ADVISED - Hair Extension Guests

{fname}, Thank you for taking an interest in Bloom Beauty & Extension Co. to provide you with the hair of your dreams!

Our services are only offered at Bloom Beauty & Extension Co. We are located at 5799 West Maple Road Suite 167, West Bloomfield MI, 48322

FIRST TIME GUEST EXPECTATIONS

*Scheduling a consultation can take up to three weeks depending on yours and our current availability.

*Your install appointment is typically between 2 and 6 weeks from your consultation depending on if you need any other services ( such as color or keratin ) before your installation.

**Overall, the process can take between 4 and 6 weeks to complete.

Most first time clients can expect to invest $1,200* to $2,200* for us to work together getting you the hair of your dreams.

This investment covers your Hair Extensions, Luxury Color, Cut and Styling. Plus, a swag bag of all of the first time products and tools you need to ensure the health and longevity of your new hair.

*A $500 NON Refundable Reservation Retainer will be due at time of scheduling and will be subtracted from your balance at the end of your session.

RETURNING GUEST EXPECTATIONS

For our returning Hand-Tied Hair Extension and Mesh Integration Guests you can expect the following:

Re-tighten Hair Extensions every 6-8 weeks.

Replacement of Hand-Tied wefts every 6-12 months with brand new hair.

Some choose to refresh some of the hair sooner than later, and this comes with additional investment.

A usual tighten and color touch up ranges between $400 - $600*

*All pricing subject to change.
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PLEASE BE ADVISED - Cezanne Keratin Smoothing Guests

{fname}, Thank you for taking an interest in Bloom Beauty & Extension Co. to provide you with the hair of your dreams!

Our services are only offered at Bloom Beauty & Extension Co. We are located at 5799 West Maple Road Suite 167, West Bloomfield MI, 48322

FIRST TIME GUEST EXPECTATIONS

*Scheduling your appointment can take up to three weeks depending on yours and our current availability.

Most first time clients can expect to invest $300* to $500* for us to work together providing you with smooth, silky, and visiably healthier looking hair.

**A $100.00 NON Refundable Reservation Retainer will be due at time of scheduling and will be subtracted from your balance at the end of your session.

*All pricing subject to change.
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PLEASE BE ADVISED - Luxury Color Guests

{fname}, Thank you for taking an interest in Bloom Beauty & Extension Co. to provide you with the hair of your dreams!

Our services are only offered at Bloom Beauty & Extension Co. We are located at 5799 West Maple Road Suite 167, West Bloomfield MI, 48322

FIRST TIME GUEST EXPECTATIONS

*Scheduling a consultation can take up to three weeks depending on yours and our current availability.

**Overall, the process can take between 4 and 6 weeks to complete.

Most first time clients can expect to invest $200* to $500* for us to work together getting you the color of your dreams.

This investment covers your Luxury Color, Cut and Styling.

***A $100.00 NON Refundable Reservation Retainer will be due at time of scheduling and will be subtracted from your balance at the end of your session.

RETURNING GUEST EXPECTATIONS

For our returning Luxury Color Guests you can expect the following:

Color touch up every 6-8 weeks.
Color maintence packages start at $130
*All color services include either a haircut OR a luxury conditioning treatment customized for you by your stylist.

**All prices listed are base prices and vary by service provider.

***Package pricing may vary based on length density and starting point.
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{fname}, having fully reviewed the financial commitments, timeline, and guidelines for the service(s) you’ve selected, are you prepared to make the necessary investment to achieve your desired transformation?* This field is required.
Yes
No
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What Is Your Preferred Method of Contact To Schedule Your Consultation?
Text
Phone Call
Email
Should be Empty: