Digital Consultation Form

Welcome. We're so glad you're here.

Our goal is to help you discover the right hair solutions with expert guidance and genuine care, so you feel confident and well-supported from the start. Please take a moment to complete this form so we can better understand your needs. A member of our team will be in touch within one business day via email or phone. Be sure to check your junk folder just in case.
Full Name*

First NameLast Name
Address*

Street Address

Apt #

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Would you like to request a specific stylist?

AngelaMollyFirst available
How did you find/hear about us?*
Have you received a professional diagnosis related to hair thinning or hair loss?*

YesNo
If you marked YES, please provide more details on your diagnosis. (e.g., Alopecia, Telogen Effluvium, Androgenic Alopecia, Postpartum Hair Loss, etc...)
What are your main concerns and/or goals for your hair? Select all that apply.*

Enhancing volume/fullness to natural lengthAdding no more than about an inch to my natural lengthWanting several inches past my natural lengthSeeking full coverage on visible thinning areas on the scalpConcerns with overall thinningConcerns with hairline recessionOther
Have you ever worn hair extensions or any hair replacements/enhancements?*

I've had extensions in the pastI'm currently wearing extensionsI've never had extensionsI wear a topper occasionallyI wear a topper or a wig anytime I am out in publicOther
Do you have weekday daytime availability?*

YESNO
All photos submitted are PRIVATE and are never shared or used outside of this form.

When taking photos, please take with your hair down (no messy buns, hats, braids, ponytails). Don't worry about looking your Sunday best! We're just looking for a current photo of your hair and/or scalp.
Current Hair Photo (no filter). We are looking for a front or side photo with your hair down. Please no hats, braids, ponytails, messy bun, etc...*

Browse Files

Cancelof
Current Photo of any areas on the scalp you are hoping to cover (no filter).

Browse Files

Cancelof
Inspiration/Desired Hair Photo (If you have one. If you don't, that's ok!)

Browse Files

Cancelof
Feel free to upload an additional photo here if there’s something else you’d like us to see.

Browse Files

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Is there anything else you’d like to share that would help us better understand your hair history, preferences, or goals?
Sometimes, we can accommodate appointments outside of our normal working hours that may help to find sooner availability. These "Premium Rate Appointments" are priced 100% higher. Would you like to be notified of any Premium Rate Appointments?*

YESNO
*THE INFO BELOW IS FOR MESH INTEGRATION/HAIR LOSS GUESTS ONLY. THIS DOES NOT APPLY TO GUESTS WANTING TRADITIONAL EXTENSIONS.

*The hair loss solution we offer requires regular maintenance to keep both your hair and scalp healthy. It will require visits every 4–6 weeks. These services are best suited for guests who can commit to consistent upkeep to protect their investment and ensure the best results.

First time client timeline expectations:

There is a $50 fee for consultations, whether in-salon or virtual. If you choose to move forward with services with us, your $50 consultation fee will be applied toward your new set application. If additional consultations are needed, they will be complimentary.

Please note:
• Consultation availability may take up to 4 weeks depending on our current schedule.
• Most crowns are custom-ordered for each guest and CAN take up to 4 months to arrive.
IMPORTANT: We will 100% reply to your submission, but please make sure to check your junk mail if our response doesn’t show up in your regular inbox.

We're looking forward to working with you and helping you achieve your dream look.

With care,

The Bespoke Crown Team
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Welcome. We're so glad you're here.