• K-Tip Intake Consultation Form

  • Customer Information

  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • Appointment Desired Date (Availability Limited)

  • Hair History

  • What is the current condition of your scalp?
  • Date of Last Chemical Service
     - -

  • Hair & Scalp Assessment

    *Please be honest to the best of your ability*
  • How would you describe you natural hair texture?
  • How would you describe your hair density?
  • Is your hair currently relaxed, texturized or natural?
  • Do you currently have any of the following scalp conditions?
  • Have you experienced excessive shedding or hair loss in the last 6 months?

  • Hair History

    *Please be honest to the best of your ability*
  • Have you worn any of the following extension methods before?
  • Have you experienced damage or breakage from extensions?
  • Rows

  • How ready are you for K-Tips? 🤔

    *These questions are heavily determined on whether you will be a good candidate for this service*
  • Rows

  • What is your Desired Outcome? 😉

    *Check all that apply*
  • What is your primary goal with K-Tips?
  • What is your desired inches? (Hair is included in total cost 😍, each.. Ex: Full install 3 (bundles) of 18inches= 300grams)
  • Desired Look:
  • How do you typical wear your hair?

  • Lifestyle & Maintenance ⛱️🏋🏾‍♀️

  • How often do you work out or sweat heavily?
  • How often do you swim?
  • How often do you shampoo your hair?

  • Hair Investment & Policies 💇🏾‍♀️💰

    *You are almost done*
  • Are you aware that K-Tip Services require a non-refundable deposit of $250 (it goes towards the final total of service)?
  • Do you understand that this service includes hair provided by the stylist only (no outside hair accepted)?
  • Do you understand that once consultation has been completed, reviewed, approved, and deposit fully paid, only then can an official appointment for K-Tip installation can be placed?
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  • Acknowledgment

  • Accuracy of Information

    • I confirm that all information provided in this consultation form is complete, truthful, and accurate. I understand that withholding or misrepresenting information regarding my hair, scalp, health history, or previous services may affect the outcome of my K-Tip installation.

    Service Suitability & Right to Refuse

    • I understand that my hair and scalp will be evaluated prior to installation and that the stylist reserves the right to modify, postpone, or decline the service if my hair is not deemed suitable for K-Tip extensions at the time of my appointment.

    Longevity & Maintenance Commitment

    • I acknowledge that K-Tip extensions are a long-term install (approximately 4–6 months) and require consistent at-home care, adherence to aftercare instructions, and professional maintenance appointments.

    Risk & Responsibility Awareness

    • I understand that failure to follow maintenance guidelines—including improper care, excessive tension, missed maintenance visits, or lifestyle neglect—may result in slippage, matting, breakage, or hair loss, and these outcomes are not the responsibility of the stylist.

    Hair, Pricing & Deposit Policy

    • I acknowledge that final pricing is based on hair length, density, and desired result. I understand that a non-refundable deposit is required to secure my appointment and that all hair used for this service is provided by the stylist only. Outside hair is not accepted.

     Removal Policy

    • I understand that removal must be performed by MeLana

      *Results Disclaimer*

    • I understand that individual results may vary based on natural hair condition, lifestyle, and maintenance routine. While every effort is made to achieve my desired look, specific results and longevity cannot be guaranteed.


    • By signing below, you agreed that you have read and understood the terms and agreement above.
  • Date Signed
     - -
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