TCR Hair System Consultation Form
Please fill out the form below to help us understand your needs and preferences for hair systems.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
*
Please Select
Email
Phone Call
Text Message
What brings you in today?
Thinning hair
Bald spots / hair loss
Scalp sensitivity
Previous hair replacement experience
Other:
Have you ever worn a hair system, wig, or topper before?
Yes
No
If yes, please share details about your experience with hair systems, wigs, or toppers. What did you like/ didn't like?
What’s your main goal with a hair system?
Confidence boost
Fuller appearance
Camouflage receding area
Big transformation
Other
What’s your lifestyle like? (Select all that apply)
Gym/Active
Swim frequently
Outdoor job
Sit-down/office job
Travel often
How often are you comfortable coming in for maintenance?
Every 2–3 weeks
Monthly
Every 6–8 weeks
Unsure
What concerns or fears do you have about hair systems?
How important is a natural-looking hairline to you?
not very
1
2
3
4
very
5
1 is not very, 5 is very
Do you have any scalp conditions or allergies we should know about?
Yes
No
Please specify
Are you comfortable with adhesive-based applications?
Yes
No
Not sure yet
What made you reach out to us?
Instagram
Facebook
Word of mouth
Google
Other
Anything else you’d like Bri to know before your appointment?
Submit
Should be Empty: