Hair By Johna

What is your name?*

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

example@example.com

How did you hear about me?

InstagramFacebookFriendOther

Have you had extensions before?

YesNo

If so, what kind/method?

Did you have any problems and/or damage with your previous hair extension method?

What is your biggest concern with hand tied extensions?*

What are your reasons for wanting hair extensions?*

Which of the following most closely describes your hair texture?*

FineMediumCorse

What is your hair type?*

StraightWaveyCurly

Is your hair color treated?*

YesNo

What is your hair density?*

Is your scalp...*

OilyDryNormal

Do you have a sensitive scalp or skin?*

YesNo

Other Considerations

Are you allergic or sensitive to any adhesives, metals, or hair/skin products?

Are you currently taking any medication that has side effects that can cause hair thinning and/or hair loss? Do you have thyroid issues? Or vitamin deficiency issues?

Do you have now, or have had in the past, any problems with hair loss (shedding, breakage, balding, alopecia, thinning hairline, psoriasis of the scalp, eczema on the scalp, etc)? If yes, have you seen a dermatologist?

Do you have any damage due to previouse chemically treated hair treatments?

If yes to any of the above questions please explain here, otherwise type no.*

I am ready for this! Lets schedule a consultation!*

Heck yes!Let's do this!

Invisible Bead Extensions (IBE)