Hair Extensions Consultation
Name
*
First Name
Last Name
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Social Media
Instagram, Facebook, etc.
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Lifestyle Analysis
Please select all that apply
Your Desired Style:
Classic
Modern
Trendy
Natural
Hair Goals:
Change with the seasons
Subtle change once a year
Have a major change in mind
Love to change every visit
Styling Spent at Home:
Less than 15 mins
15 - 30 mins
30 - 45 mins
More than 45 mins
Versatility:
Wear my hair the same everyday
Occasionally wear my hair differently (weekends, etc.)
Open to new styles & change often
Try a new look everyday/other day
How you typically style your hair:
Air dry or lightly diffuse
Blow-dry with a flat brush
Blow-dry with a round brush
Blow-dry with a brush & use a hot iron
Styling Comfort Level:
Uncomfortable: I need a start to finish lesson/help
Comfortable: I need tips/help on…
Very Comfortable: I can style my hair with ease. Open to new techniques.
Scalp Sensitivity:
Extremely Sensitive: Always hurts to wear a ponytail, clips, or brush
Somewhat Sensitive: Sometimes hurts when detangling
Not Sensitive: I am not sensitive
Medications that could cause hair loss:
No Medications
Have taken them in the past
Taking medications but not sure
Taking medications: In active hair loss
Do you wear hair extensions, hair additions, or hair pieces?
Not Now
Sometimes for an event
Regularly
I'm wearing them now
Health Challenges within the Last 6 Months:
None
Thyroid Disorder
Diabetes/Anemia
Unexplained Hair Loss
Recent Pregnancy
Other
Currently, how many good hair days do you have per month?
1 - 7
8 - 15
16 - 22
23+
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I am Most Challenged/Concerned with: (Please select all that apply)
Repairing Damage
Adding Moisture
Preserving Color
Corrective Cut
Enhancing Color
Corrective Color
Thinning Hair
Adding Fullness
Hair Loss
Enhancing Volume
Creating Length
Coverage
Smoothing Frizz
Straightening
Enhancing Curl
Styling
Boredom
Sparse/Thin Ends
Duplicating
Other
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Current Volume: On a scale of 1 to 10 (10 being the thickest, healthiest & most voluminous, 1 being thinnest)
Thinnest
1
2
3
4
5
6
7
8
9
Thickest, Healthiest, & Most Voluminous
10
1 is Thinnest, 10 is Thickest, Healthiest, & Most Voluminous
Desired Volume:
Thinnest
1
2
3
4
5
6
7
8
9
Thickest, Healthiest, & Most Voluminous
10
1 is Thinnest, 10 is Thickest, Healthiest, & Most Voluminous
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What is perfect hair for you? If you could wave a magic wand, describe how you would want your hair to look, act, and feel?
Desired Length: Upload a picture of how long you would like your hair to be
Browse Files
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Color: Compared to your current color, do you want your results to be...
Lighter than current shade
Darker than current shade
Same as current shade
Other
Would you like your desired hair color to...
Whisper
Talk
Scream
What does your dream hair look like? Upload a photo, or a few, of what you would like your hair to look like
Browse Files
Drag and drop files here
Choose a file
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Submit
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