Hair Extension Consultation Form
Please provide your details and preferences for your hair extension consultation.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What is your current hair length?
*
Please Select
Short (above shoulders)
Medium (shoulder length)
Long (below shoulders)
What is your natural hair texture?
*
Straight
Wavy
Curly
Coily
Other
What is your current hair colour and is it dyed?
*
Have you had hair extensions before?
*
Yes
No
If so what type of hair extension method?
*
Tapes
Weft or clip ins
Nanos
Bonds
Other
Do you currently have hair extensions fitted?
*
Yes
No
Are you experiencing the following?
*
Hair loss
Hair thinning
Scalp sensitivity
Breakage
None
Are you on any medication that will cause hair loss or thinning?
Yes
No
What is your main goal for getting hair extensions?
*
Add length
Add volume
Change style
Special occasion
Other
What type of hair extension method are you wanting to use?
*
Tape
Weft
Partial nanos
Mixture
Not sure
Do you have any scalp conditions?
*
Eczema
Psoriasis
Dermatitis
Sensitive scalp
Other
Do you have any known allergies or sensitivities (e.g., adhesives, metals)?
Additional comments or questions
I confirm all information provided is accurate and complete and that I understand hair extensions require regular maintenance and aftercare. I understand that results may vary depending on the condition and suitability of my natural hair.
*
I confirm and understand
Submit Consultation Request
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