Hair Extensions Intake Form

Welcome and thank you for taking the time to fill out my pre consultation form. Below you will find a short questionnaire for me to get a better understanding of your hair history and what you would like to achieve.

Full Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

These questions are important for me to know prior to your in person consultation. This will give me a better idea of what extensions would best suit your wants and needs.

My hair is:

Please indicate if any of the following apply to your scalp condition

Do you have any allergies to metals, adhesives or latex ?

Have you been pregnant in the last 6 months?

Do you suffer from any form of hair loss?

Have you ever been diagnosed with alopecia?

Do you take any medications such as hormonal medications, thyroid meds, acne and skin treatments, antidepressants, blood pressure medications, steroids, chemotherapy, allergy meds, and some herbal supplements that would interfere with hair loss or extreme shedding?

If yes, which one (s):

Do you have a sensitive scalp?

Do you suffer from psoriasis or eczema to the scalp?

Do you frequently swim or go to the gym?

Do you currently color your hair?

If yes please inform of what you have done color wise

Have you ever had hair extensions done before?

If yes, please inform me of which ones you had.

What kind of Hair Extensions were you considering?

Ideal length looking to achieve?

Should there be any other important information I need to be aware off please indication in the box below.

Whether you’re looking to add length, fullness, or all of the above, my customizable extensions could be exactly what you need.

Your in person consultation will determine final price based on your current hair and hair goals. The initial installation package begins at $350+ for a full head install. I recommend setting aside 3+ hours for this first appointment, which is the longest. (More time needed if we are doing a custom color)

A 50% non-refundable deposit on the hair is due at the end of our in-person consultation if you choose to move forward with the install appointment. You will receive an invoice to your email provided. Your remaining balance on the hair will be due prior to your install appointment.

Maintenance appointments are recommended every 4-6 weeks. You can add to your experience, colour maintenance to your natural hair, refreshing custom colour & toning extensions, conditioning treatment, cutting & blending (if necessary), and styling. 

You can expect to purchase new hair every 8-12 months, sometimes sooner if the hair isn't properly cared for.

Thank you kindly for taking the time to fill out this form :) I am looking forward to working with you and your hair journey!