Hair Extension Consultation and Agreement Form

Hair Extension Consultation Form

Hair by Jordan Bono
Client Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Hair Condition & Goals
What is the current length of your hair?
What is the current color of your hair?
Are you wanting to change the current color of your hair? If so, please provide hair color history.
Are you looking to add length, fullness, or both?
NormalDryOilyScarsOther

Pre-Install Questions

Rows	Yes	No	Comments
Have you ever had hair extensions before? If so, what method?
Do you have a medical condition where hair loss is present (i.e alopecia)?
Are you currently in treatment and/or taking medication for hair loss?
Do you have any skin-related illnesses or known allergies?
Are you pregnant/postpartum and experiencing shedding?
Will you use professional products?
Can you commit to maintenance appointments every 6-10 weeks?
Do you regularly go to gym/workout and sweat heavily?
Do you regularly swim in chlorine or saltwater?
Are you willing to make the necessary changes to properly take care of your hair?
Do you frequently wear tight ponytails, slick styles, hats, or helmets?
Are you prepared for the financial investment of install, maintenance, and hair replacement?

Please upload an image of your current hair in natural lighting! (Front, sides, & back)
Right Side
Left Side
Back of Head
Please upload an image(s) of your hair goals!

Cancelof
Acknowledgment
- I confirm that all information I entered in this form is accurate and true.
- I understand that I need follow pre-procedure and post-procedure care.
- I understand that for cancellation or rescheduling, I need to contact my stylist directly 24-48 hours prior and receive confirmation.
- I understand the risks of having hair extensions, such as scalp irritation or traction alopecia.
- I release the salon and stylist for any liabilities and/or hold harmless for any damages, injury, or accidents that can happen during or after the appointment.
- I understand that removal must be performed by a hair stylist for proper removal to avoid damage.
By signing below, you agreed that you have read and understood the terms and agreement above.
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Hair Extension Consultation Form