Topper/Extension New Client Form

Welcome to the world of hair toppers! Hair toppers offer a versatile and non-invasive solution for those experiencing thinning hair or hair loss. They add volume and coverage, blending seamlessly with natural hair to create a fuller look. Toppers are lightweight, comfortable, and come in a variety of styles, colors, and lengths to match individual preferences. Unlike full wigs, they cover only specific areas, making them ideal for enhancing certain sections while maintaining the overall integrity of natural hair. Plus, they're easy to apply, providing an instant confidence boost without the commitment of permanent treatments.
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Instagram
@example
Have you ever worn a hair topper before?*
Do you have a budget for your topper?*
(Please note: the average initial investment is $800 - $1600 for the hair piece, customization and installation.Toppers can last a year plus depending on maintenance and at home care.)
Goals for topper:*

Cover Thinning HairCoverage for my grays/no more color maintenanceCover undesired hair textureOther
If you have thinning hair, where are your problem areas?:*

CrownBangsTemplesOther
Upload photo of CURRENT hair in natural light.*

You can upload multiple files here
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Upload inspiration photos here.*

You can upload multiple files here
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How long is your natural hair?

ShortMediumLong
Describe the status of your scalp.

DryNormalOilyOther
Describe your hair by checking the options below (you can select more than one):

HealthyDamagedStraightWavy CurlyFineThickThinningOther
Do you have any specific questions or concerns?
Do you have availability daytime Monday - Friday for appointments?*

YesNo
How did you hear about me?*

FacebookInstagramNext DoorOnline AdvertisementGoogle SearchReferred by a friend (Ask about referral program!):Friends Name
Your submission will be reviewed and you will receive an email response with topper options, pricing and next steps, including a link to book an in-person consultation.
Signature*

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Please sign before submitting.
Date Signed*

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Date
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