ARE YOU READY TO REGAIN YOUR CONFIDENCE?
Congratulations on taking the first step toward finding the best hair loss solution for you. At Great Hair Day, we specialize in personalized, natural-looking hair restoration options tailored to your needs and lifestyle. Our team is here to guide you through the available solutions and help you achieve your desired look with confidence and care. Please fill out the information below to submit your application. We will be in touch with you soon.
Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
How old are you?
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How did you hear about me?
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Google
Facebook
Instagram
Referral
Other
Instagram Handle
Have you been professionally diagnosed with hair loss or thinning?
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Yes
No
Not Yet
If You Marked YES, please tell us about your clinical diagnosis? (e.g., Alopecia, Telogen Effluvium, Androgenic Alopecia, Postpartum Hair Loss, etc.)
If You Marked NO, please describe your hair loss to help us better understand your unique situation
When did you first start noticing hair loss?
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Have you tried any medical/clinical treatments or solutions such as medication, PRP, vitamins, and/or oral/topical creams or shampoos/conditioners/treatments, etc? If so, please list them and describe your experience.
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Have you tried any cosmetic treatments or solutions such as hair replacement, tattooing, crowns/toppers/wigs/extensions, fiber sprays, etc? If so, please list them and describe your experience.
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What are your main concerns regarding your hair loss?
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Do you have any sensitivities to latex, adhesives, tapes, or other hair enhancement products?
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Yes
No
Not Sure
What would you like to achieve in your hair replacement journey?
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Are you looking for a temporary (can be removed daily) or permanent (can't be removed at home) solution?
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Temporary
Permanent
Other
If there is a specific hair replacement method that you are interested in learning more about, please let us know below
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Hair Color
Is Your Hair Currently Colored
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Yes
No
If so are you happy with your color?
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Yes
No
Are You Looking To Change Or Update Your Current Color?
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Yes
No
If Yes, In Which Direction Would You Like To Go?
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Other than hair loss, do you have any particular areas of concern?
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Time Commitment
Our studio requests that every hair loss guest comes in for a face to face consultation prior to your appointment. Would you be willing to devote 45-60 minutes to discuss your hair goals and review your options with an expert from our team?
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Yes
No
All of the hairloss solutions that we offer require some form of maintenance to keep your hair and scalp healthy, and to keep you looking your best. Most are anywhere between 4-6 weeks. Would you be willing to commit to coming in to maintain your look?
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Yes
No
HAIR PHOTOS
Follow the Instructions Below To Upload Your Current Photos.Must Be A Photo Of Your Current Hair.Use Your Cell Phone. (Professional Camera Images Are Too Large To Upload Into Our Form)For best results, Have a trusted friend or family member take the photo for you if possible.Take your photos in a well lit area such as in front of a window with access to natural light or outside in covered shade. (Please no harsh lighting or flash)We need 4 photos of you—Front (facing the camera), the back of your head (looking straight ahead), back (looking up so we can see the top of your head), close up of your area(s) of concern.Please Send At Least 2 Inspirational Photos. (Images Of What You Are Trying To Achieve)Upload Photos Below:
Front Photo
Browse Files
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of
Back Photo
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Top of Head
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Area(s) of Concern
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Inspiration (show us your dream hair)
Browse Files
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of
FIRST-TIME CLIENT TIMELINE EXPECTATIONS
*Scheduling a consultation can take up to three weeks depending on current availability. *We custom order crowns that are custom to each guest, which can take up to 6 months to arrive in the studio. Depending on the method that is chosen for you during your consultation, you may be asked to come in for a measurement, design, and/or fitting appointment prior to your installation appointment. Having full knowledge of the financial commitments, timeline, and guidelines to obtain and maintain your extensions, are you prepared to make the investment necessary to experience the most natural looking hair extensions?e a question
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Yes
No
By checking this box, I consent to receive non-marketing text messages from Great Hair day about mesh integration/extensions. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.
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Yes
By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from Great Hair Day at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.
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Yes
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