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The Hair Extension Headquarters
Contact
Home
The Salon
Online Booking
The Hair Extension Headquarters
Contact
Consultation Form
Hair Extension Consultation and Cost Form
Name
*
First Name
Last Name
Email Address
*
Cell Phone
(###)
###
####
HAIR HISTORY
Current State of Hair
*
Natural
Relaxer/Chemical Treatments
Date of Last Relaxer
MM
DD
YYYY
Any Color?
*
Full Color
Highlights
Streaks
Ombre
Grey Coverage
N/A
Have you ever been treated by a doctor for hair loss or scalp problems?
*
Yes
No
Do you presently have any hairline breakage, thinning areas, or bald spots?
*
Yes
No
Have you ever had any allergic response or adverse reactions to products or substances put onto your skin or scalp?
*
Yes
No
HAIR WEAVE & EXTENSION HISTORY
When was your last install?
*
Have you ever received or currently have the following hair weave or extension services? Check all that apply:
Bond/ Glue
Sew In
Wig
Hair Unit/Replacement Wig
Lace Closure
Lace Frontal
Microlinks
Fusion
Tape In
Other
Are you presently wearing weave or extensions?
Yes
No
If so what type? And is hair left out?
How long does your weave/extension style last?
HAIR MAINTENANCE
How often do you shampoo & condition your hair?
*
Daily
Twice a week
Once a week
Every 2 weeks
Every 3 to 4 weeks
Other
What name brand products are you presently using in your hair?
*
Do you have any scalp issues (ie: Dry, itchy, dandruff)?
*
Yes
No
If so explain:
How often do you oil your scalp?
*
How often do you use curling irons, flat irons, blow-dryer or any other hair heated appliances?
*
How often do you visit the salon?
*
LIFESTYLE
Do you exercise consistently? If so how often? And do you perspire heavily?
How do you care for your hair during workouts?
What is your nighttime hair care routine?
Thank you!