Hairloom Extensions and Styling Inc.

Hair Extension Pre Consultation Form

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I'm so glad you're here! Thank you for considering Hairloom Extensions and Styling for your hair extension needs.
What is your full name? (required)
What is your e-mail? (required)
What phone number can I reach you by? (required)
What city and state are you located in? (required)
How did you find me? (required)
What is your age range? (required)
When is your birthday? (required)
Please select your answer for the previous question... (required)
Which of the following describes your natural hair? (required)
How would you describe your natural hair texture? (required)
Is your hair currently colored? (required)
What is your experience with wearing hair extensions? (required)
Do you have any areas of concern? Excessive shedding, balding, alopecia, scarring, breakage, etc.? (required)
Front Photo (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Back Photo (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Side Photo (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Temple Photo (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Please upload a picture of the hair color you wish to achieve during our session (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Please upload a photo of the hair length you would like to achieve during our session (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Which describes you best? (required)
When scheduling your appointment, I have weekday availability at 11:00am EST. Can you make this work? (required)
Now that you are clear on the financial investment and maintenance, are you ready to make your dream hair a reality?! (required)
Final step
Your contact details
We’ll use this to attach your responses.