Hair Extension Consultation Form
Please enter a valid phone number.
Are you over 18?
What is the length of your hair?
What is the color of your hair?
What is the current condition of your scalp?
Health and Lifestyle Questions
Have you had hair extension before?
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 or use a sauna?
Have you been pregnant for the last 6 months?
Do you usually go to a gym for a workout?
Do you wear glasses?
Desired Hair Length
Please upload an image of your current hair
Please upload an image of the hair that you want or your inspiration
Drag and drop files here
Choose a file
I confirm that all information I entered in this form is accurate and true.
By signing below, you agreed that you have read and understood the terms and agreement above.
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