Hair Extension Client Request

Hair Extension Client Request
Every hair extension appointment starts with a thorough consultation.

This required form, will provide the beginning insight
needed to make your extension consultation seamless & efficient.

Once the completed form is received you will be contacted (within 24-48 hrs)
to set up your in-person consultation.

The in-person consultation is $50 & scheduled for 30-45 mins.
This $50 will be applied toward your installation cost
when moving forward with the service.
- In-depth consultation & color matching
- Bellami Hair Pro installation
- Complete knowledge of at home care & maitenance routine
- Referral discounts to future maitenance services
Contact information
Name

First NameLast Name
Instagram
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
How did you hear about the Salon?
If Referral, who Referred you?
First & Last Name
Check- in
What type of change are you considering with your hair?

Minimal, only MaintenanceMaintain with minor changeI’m ready for a MAJOR change
Have you had hair extensions before?

Yes, and I’m ready for my glow up!Yes, but didn’t have a great experience.No, first time!
Are you familiar with Bellami Hair?

Yes, that’s why I’m here!Not really but Excited to learn more!
What are your goals with hair extensions?

VOLUMELENGTHGirl, give me BOTH!
Hair Condition
What is the Current length of your hair?

Short/Above shouldersMedium/touching shoulders to heartLong/Past shoulders to waist
Choose the option that best describes your hair type?

FineMediumThickExtremely Thick
Choose the option that best describes your hair texture?

StraightWavyCurlyCoily (tight curls)
Have you ever Colored your hair?

Yes, currently.Yes, but it’s been a whileNever, virgin hair.
Have you ever used Henna hair color?

YesNo
If yes, what is your hair color history of the past 12 months?
What is the current condition of your scalp?

NormalDryOilyOther
Please upload ONE photo of your hair [facing the camera] in natural lighting [sunlight is preferred].
Please upload ONE photo of your hair from the side [looking over your shoulder also in natural lighting]. This allows us to see the back of your hair.
Please upload ONE inspo photo that would be an end goal for you!

Cancelof
I understand that my overall goal may not be achieved in one session depending on what needs to be changed or corrected.

Yes, I understand
Hair Care
How often do you wash your hair?

1 x per week2 x per weekEvery other dayEveryday
What current products are you using on your hair? (Shampoo/conditioner/styling products)
How often do you use heat your hair?(Blowdry,Curling,Flat ironing, etc.)

EverydayEvery other day2 x per weekOnce a week
Are you willing to invest in proper products suggested by your stylist to benefit & maintain lasting results?*

Yes, absolutely

Pre-procedure questions

Rows	Yes	No	Remarks
Do you have a medical condition wherein hair loss is present like alopecia?
Are you currently in treatment for hair loss?
Are you currently taking medication for hair loss?
Do you have any skin-related disease?
Do you have any allergies?
Are you sensitive to metals?
Do you regularly swim?
Have you been pregnant for the last 6 months?
Do you usually go for a workout?
Do you have any upcoming surgeries?

Acknowledgment
- I confirm that all information I entered in this form is accurate and true.
- I understand that I need to follow pre-procedure and post-procedure care.
- I understand that for cancelation or rescheduling, I need to contact the salon directly. Cancellation Policy-
  
  When booking a service you will be required to leave a credit card on file.
  
  We require a 24-hour notice of cancellation or it will be considered a “no show”.
  
  We take pride in the services and experience we offer our guests. To ensure each guest is able to enjoy their full experience please arrive 10-15 minutes prior to your scheduled appointment time. Late arrivals will be rescheduled after 10 minutes.
  
  1st TIME NO-SHOW: Your Credit Card on file will be charged for 50% of your booked service.
  2nd TIME NO-SHOW: Your Credit Card on file will be charged for 100% of your booked service. Further bookings will require prepayment of service.
  
  Please understand that when you forget or cancel an appointment without giving enough notice, we miss the opportunity to fill the appointment time, and clients on our waiting list miss the opportunity to receive services.
  
  As a courtesy, we will text or email to confirm your service 72 and 24 hours prior to your scheduled appointment. However, if we are unable to reach you, it is your responsibility to notify us in the event that you need to cancel or reschedule prior to 24 hours before the service.
- I confirm that the clinic does not provide a refund for deposit payments.
- I released the salon for any liabilities or hold harmless for any damages, injury, or accidents that can happen during or after the procedure.
- I understand that removal must be performed by a hair salon technician or extensionist.
By signing below, you agreed that you have read and understood the terms and agreement above.
Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

Hair Extension Client Request

Contact information

Check- in

Hair Condition

Hair Care

Acknowledgment