Hair Extension Consultation Form

Please fill out and answer the following questions to help us better understand your needs.

"*" indicates required fields

Name

First Last

Email*

Date*

How did you hear about our hair extensions services?*

What is your reason for wanting hair extensions?*

Have you worn hair extensions before?*

Yes

Are you interested in hair extensions as a long-term option for styling your hair?*

Yes

What is the longest your hair will grow on it's own?*

When was the last time you let it grow to that length?*

What was your reason for cutting it?*

What is your normal maintenance program? Please list all products you use at home and the frequency with which you use them.*

How often do you visit the salon for maintenance and touch-up services?*

How often do you get hair coloring services? (Leave blank if you do not get hair coloring done)

How often do you get perms or relaxers? (Leave blank if you do not get perms or relaxers)

How often do you get highlighting or foils? (Leave blank if you do not get highlighting or foils)

How often do you like to change your style?*

What is the long term goal for your hair?*

Do you have any allergies (chemicals, medication, substances, materials, or other?) If so, what are they?*

Do you have any medical conditions that may interfere with this service? ie. Migraine headaches, history of scalp problems...please explain.*

Are you presently experiencing an unusual amount of hair loss (reason: Chemotherapy, stress-related alopecia, etc.)*

List special interests and hobbies along with workout and sport activities below*

Please write questions or main areas of concern regarding this service.*

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