Mane Reflection Digital Consultation Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
City, State* This field is required.
5
How'd you hear about us?* This field is required.
Instagram
Facebook
Google
Yelp
Met in Person
Referral from a Friend
Other
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Who was it that referred you?* This field is required.
7
Have you had adverse reactions to cosmetic services or any allergies I should be aware of?* This field is required.
YESNO
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Please explain your adverse reaction and/or allergies* This field is required.
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Large
Normal
Small
Ok
Ok
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Please select all the services you are looking to get done* This field is required.
Sugaring
Haircut
Color
Extensions
Scalp Treatment
Makeup
Facial Wax
10
Are you pregnant?* This field is required.
YESNO
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Have you ever sugared before? * This field is required.
YESNO
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How long ago did you sugar?* This field is required.
3-4 weeks ago
5-6 weeks ago
6+ weeks ago
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What are you looking to achieve with Hair Extensions?* This field is required.Please Select All That Apply
Length
Fullness
Highlights/Color
Other
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Do you currently have hair extensions in? Have you had them before?* This field is required.
I do not have hair extensions in and have never had them before
I currently have hair extensions in my hair
I do not have hair extensions in but have had them before
Other
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Mane Reflection Service Menu
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Mane Reflection Service Menu
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In the next question I'll be asking you to describe your hair density. Please review these examples...
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What do you believe best describes your hair density?* This field is required.
Extra Light
Light
Medium Light
Medium
Medium Heavy
Heavy
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In the next question, I'll be asking you to describe your hair length. Please use this image for reference.
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In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?* This field is required.
Short
Medium
Long
Extra Long
21
Your hair history in the last 3+ years.* This field is required.
I have colored my own hair.
I have not colored my hair in 3+ years.
I have gotten my hair colored professionally.
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What hair color/product did you use? Please Check all that apply.* This field is required.
From Sally's Beauty Supply
From Online
From Drugstore/Grocery Store
Box Dye
Splat
Overtone
Temporary Hair Color Rinse
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(OPTIONAL) Please upload a clear photo in neutral lighting of your hair as it is now
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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(OPTIONAL) Please upload an inspiration photo of what you'd like to achieve with your hairYou can find one in google searches, screenshots of Instagram posts, or Pinterest posts
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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In your own words, please share what you'd like done - and any other questions/comments/concerns for me.* This field is required.
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Large
Normal
Small
Ok
Ok
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Cancellation Policy
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Please agree to our policies to submit the form* This field is required.
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If you will be receiving sugaring services with me, please follow these important instructions:

- Please do NOT shave 10-14 prior to your service.
- NO lotions or oils the day of your service.
- Please exfoliate 24 hours BEFORE your appointment (not any sooner than that).
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You're about to be redirected to my online booking.

Please ONLY book a Hair Extension Consultation even if you're also interested in color, haircuts or any other services.

We will discuss booking your other services during our consultation.
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