Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Natural Hair Density * How would you describe the thickness of your hair without extensions? Fine Medium Thick Natural Hair Length * What length is your hair without extensions? Short Mid-Length Long Natural Hair Texture * How would you describe your hair texture? Straight Wavy Curly Have you ever worn hair extensions before? * Yes No If yes, what type of hair extension was it? What is your height? * How many times per week do you wash your hair? * What is your styling proficiency? * Describe your skill level with hairstyling. Low Medium High Are there any medical conditions that affect your hair health? * Yes No Please list or describe any medical conditions that we should be aware of. How long do you plant to wear your hair extensions? * 3 months or less 3-6 months 6-12 months Would you like to try something new with your hair color? * Yes No Hair extensions are considered a luxury service, but can be tailored to the individual. Please share if you have a specific budget in mind. $ Please type your full name as signature * **DON'T FORGET TO SCROLL DOWN AND BOOK YOUR COMPLIMENTARY CONSULTATION FOLLOWING YOUR SUBMISSION** Date * MM DD YYYY Thank you! Book Complimentary Extension Consult
