Hair Consultation Form

Hair Consultation Form

IBE (Invisible Bead Extensions) & Great Lengths
Select an extension service:

IBEGreat Lengths
My Products
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Invisible Bead Extensions Patented Beaded sewn weft method
$25.00 Quantity

Great Lengths ExtensionsKeratin Ultrasonic Touch cold application method
$25.00 Quantity

Total

$0.00
Client's Name

First NameLast Name
Client's Phone Number
Client's Email Address
example@example.com
Occupation
Date of Birth

MonthDayYear
Date
Upload an image of your “Inspo” picture

You can upload multiple files here
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Tell us something about your hair that you want addressed
Upload an image of your current hair

You can upload multiple files here
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How often do you go to salon for hair treatment?

Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a yearOther
How long is your hair?
Kindly describe the status of your scalp.
How often do you apply shampoo and conditioner in your hair?

Every dayEvery other dayTwice a weekOnce a weekOther
What is the current condition of your hair?

Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruffOther
Have you use the following in your hair before?

Permanent hair colorKeratin TreatmentRazor cut/ThinningRelaxerHenna
When did you last visit a hair salon?

MonthDayYear
Date
When did you last apply professional or unprofessional color in your hair?
Do you have any hair loss problems in the past?
Are you currently taking any medications? If yes, please list them below. If not, leave it blank.
Please indicate the list of hair products you're currently using:
How did you hear about us?

FacebookTwitterInstagramYouTubeOnline AdvertisementGoogle SearchReferred by a friendNewspaper/MagazineOther
Any special instructions, comments, or suggestions?
Terms and Conditions*
Client Signature

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Date Signed

MonthDayYear
Date
Payment Methods

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