Extension Consultation Form
Thank you for choosing Hair Maiden for your extensions! Please take a moment to complete this client questionnaire.
Sign in to Google to save your progress. Learn more
Name *
Email Address *
Phone Number *
Were you referred to us by anyone? If so please include their name below:
Which brand of extensions are you interested in? *
Have you worn extensions before? *
If yes, what type?
Have you ever experienced hair loss or damage? *
Have you ever suffered from Alopecia? *
Have you ever undergone any chemotherapy treatments? *
Are you on any medication that lists "hair loss" as a possible side effect? *
Do you have a sensitive scalp? *
Are you allergic or sensitive to any hair related products? *
Are you aware of the maintenance involved in wearing hair extensions? (i.e. special products and hair care instructions, touch-ups, etc.)? Please discuss with your stylist. *
How often do you wash your hair? *
What tools  do you use to style your hair? *
What heat settings do you use when styling? (temperature range)
Daily styling time: *
Do you wear your hair in a ponytail? *
Do you wear hats? *
Do you wear glasses/sunglasses? *
Do you work out? *
Do you swim? *
If so, what do you swim in more frequently? *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy