Extension Beauty Form

Name:

First NameLast Name
Best Way to Contact You:*

EmailPhone CallTextFacebook/Instagram Messenger
Email Address:
example@example.com
Phone Number (optional):
Please enter a valid phone number.
Instagram Handle (optional):
How would you describe your natural hair type?

StraightWavyCurlyCoily
How would you describe your hair texture?
How would you describe your hair density (how much hair is on your head)?
How would you describe the length of your hair?

PixieShortMediumLongVery Long
How would you describe your overall hair quality? Check all that apply.

ThinningLacks VolumeDryFrizzyDamagedDyed/ColoredBleach ProcessedMostly Healthy
How would you describe your root/scalp quality?

DryOilyBalancedFlaky/Dandruff
How would you describe the ends of your hair?

DryBrittle/BreakingSplitMostly Healthy
How do you most often style your hair? (check all that apply)

Air DryBlow Dry/DiffuseHeat Styling (Straightener/Curling Iron)
What style of hair are you wanting this visit ?
Should be Empty: