New Client Digital Consultation

1
What's your first and last name?* This field is required.
First Name
Last Name
2
What's your address?* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
What's your cell phone number?* This field is required.
Please enter a valid phone number.
4
What's your email address?* This field is required.
example@example.com
5
How did you hear of Cher?* This field is required.
Friend
Instagram
Facebook
Google
Other: Please Specify
6
What are the reasons for wanting hair extensions? Check all that apply* This field is required.
Adding slight length/volume
Adding significant length/volume
Adding volume/fullness to natural length
Adding hair to thin areas on the scalp
Adding complete coverage to cover a bald spot(s)
Other
7
Have you worn extensions or a hair piece or are you currently wearing extensions?* This field is required.
I've had extensions in the past
I'm currently wearing extensions
I've never had extensions
I wear a topper occasionally
I wear a topper or a wig anytime I am out in public
Other
8
Have you been diagnosed with a specific hair loss condition? If YES, please type answer below * This field is required.
9
What days are you available?* This field is required.Sometimes, I can accommodate appointments outside my normal working hours that may help to find sooner availability. *These are "Premium Rate Appointments" are priced 100% higher
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
10
Would you like to be notified of any "Premium Rate Appointments"?* This field is required.
YESNO
11
Please send me FIVE PHOTOS of your hair.

These are for my eyes only so that I can determine our starting point.

Instructions:

To get the most accurate representation please have a friend or use a stand with a timer set to take your images in natural, shaded light. *NO FILTERS

Take inside, stand 3-4 feet away from an open window, facing the window.

Take during the day when you can turn off the lights in your home.

One photo of the front of your hair.

One photo of the back of your hair.

One photo of the right side of your hair/head.

One photo of the left side of your hair/head.
12
Take Photo of the Front of your Hair* This field is required.
13
Take Photo of the Back of your Hair* This field is required.
14
Take Photo of the Right Side of your Hair* This field is required.
15
Take Photo of the Left Side of your Hair* This field is required.
16
Do you have any additional questions or is there anything else you think Cher should know?* This field is required.
17
Upload Inspiration Photo* This field is required.
18
Upload Inspiration Photo* This field is required.
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