Hair Extension Consultation Form

Hair Extension Consultation Form

Hair Extension Consultation Form
Client Information
Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Hair Condition
What is the length of your hair?
What is the color of your hair?
What is the current condition of your scalp?

Other

Pre-procedure questions

Rows	Yes	No	Remarks
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?
Have you been pregnant for the last 6 months?
Do you usually go to gym for a workout?

Pricing Information:

Most first time clients can expect to pay

$1,000 - $2,500 plus.

This investment covers Elite quality extensions wefts and initial install with styling. Price is evaluated by number of rows needed and desired length.

*Color is a separate charge.*
Investment:

A deposit of half of your services will be required prior to booking your appointment. This will be applied to the price of your final look!

I offer finance options through Cherry 🍒

Cash.Venmo.ApplePay.PayPal.CreditCard are also accepted.
Please upload an image of your current hair
Please upload an image of the hair that you want or your inspiration

Cancelof
Acknowledgment
- I confirm that all information I entered in this form is accurate and true.
- I understand that I need follow pre-procedure and post-procedure care.
- I understand that for cancelation or rescheduling, I need to call the salon or clinic directly and talk to the staff to get voice confirmation.
- 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
Date Signed

MonthDayYear
Date
Should be Empty: