Extension Request Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What is the current state of your hair?
*
1.Relaxed/Permed (Keeping the health and integrity of your natural hair in mind, we do not service clients with perms/relaxers)
2.Natural curls
3.Color (including bleached, grey coverage, highlights, black, etc)
4.Natural & Silk pressed
What is the current length of your natural hair?
*
1.Bob length (above shoulders/chin length)
2.Medium (at the shoulders)
3.Medium to Long (below shoulders to bra strap)
4.Extra Long (lower back or longer)
Are you currently able to put your natural hair into a ponytail?
*
Yes
No
Upload photos of your natural hair free of extensions in a ponytail
*
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Please uploads photos of your hair. Hair in a high ponytail: Front, back, and both sides. Natural light is preferred when taking photos, we just ask the photo is good lighting and where we can see your hair clearly. This is how we will determine your candidacy so please be mindful of that when submitting your photos.
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What is the current density of your natural hair?
*
Fine/Thin
Medium
Coarse/Thick
What is your current natural hair texture?
*
1A-1C / Straight
A-2C / Wavy - Loose Curly
A-3C / Loose Curly - Soft Kinky
4A-4C / Coily - Kinky
Check all that apply
Healthy (No split ends, no damagededges, all around healthy)
Thinning/Shedding
Heat Damage
Hair Loss
Breakage of any kind
Split Ends
Scalp Build Up
Dry/Itchy Scalp
Dry & Brittle
Thinning Edges
Psoriasis or Dandruff
Are currently experiencing any natural hair loss or problems.with your hair?
*
Yes
No
If yes, please leave a detailed description below *
*
Upload Inspiration photo *Upload your desired look. Keep in mind this is just inspiration, we will discuss all your options if it is determined you are a candidate for extensions
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Do you have any additional questions, comments, or details you feel we should know in regards to your Extensions appointment?
*
How did you hear about Me? *If you were referred, please share your referrals name.
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