dsm extension questionnaire
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Have you ever worn extensions before? If yes, which type and what was your experience?
What type of change are you looking for with extensions? Check all that apply:
Length
Color
Volume
Density Correction
Other
Are you looking to wear extensions only once or long term?
Only once
Long Term
Are you willing to commit to a detailed maintenance plan throughly explained to you by your certified stylist?
Yes
No
Currently how happy are you with your hair color?
Current styling time spent at home:
Less than 15 minutes
30-40 minutes
Try a new look almost everyday
How do you currently wear your hair on a daily basis?
Wear my hair the same everyday
Occasionally wear my hair different(weekday/weekend)
Open to new styles/changes often
How do you typically style your hair:
Air dry
Blow-dry
Blow-dry with brush
Blow-dry with brush & use hot tool
I am most challenged/concerned with(check all the apply):
Thinning Hair
Repairing Damage
Creating Length
Smoothing Hair
Adding Fullness
Enhancing Curl
Boredom
Other
Are you currently taking (or have taken in the past) any medications that can cause hair loss?
Yes
No
Have you had any of the following health challenges:
Thyroid disorder
Diabetes
Anemia
Unexplained hair loss
Recent pregnancy
Undergone recent surgery
Attach a photo from the front and back of your hair currently
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Anything else you want us to know:
I understand the next step is a in person consultation to go over the questionnaire. There is a $35 consultation fee to be paid at the time of booking(sent via text). This is a non-refundable fee that does not go towards your extension application or hair costs.
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