Welcome
About
Gallery
Services
Extensions
The Luna Method
Extensions
New Clients
BOOK NOW
Welcome
About
Gallery
Services
Extensions
The Luna Method
Extensions
New Clients
BOOK NOW
Name
*
First Name
Last Name
Date
MM
DD
YYYY
Phone
(###)
###
####
Email
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Have you ever worn extensions before?
Yes
No
Whats the longest you've ever grown your hair?
When's the last time you grow to that length?
What is your long term goal for your hair?
How long would you like your hair?
Where do you want to see volume?
Where do you want to see length?
What is your normal maintenance program?
What products do you use at home and how frequently?
Do you and how often do you get the following services?
Color
Highlights
Perm
Relaxer
Keratin Treatment
How often do you like to change your style or color?
Are you currently taking any medication(s) or under a physician's care?
Yes
No
Have you been ill, had surgery or on any medication(s) in the past 6 months or year?
Yes
No
Are you planning to have surgery in the next 6 months?
Do you have any allergies (chemicals, medications, substances, materials or any others)?
Do you have any medical conditions that may interfere with this service?
Are you presently experiencing an unusual amount of hairloss?
Special interests or hobbies:
What workouts or activities do you do frequently?
Do you swim regularly?
Yes
No
Any questions or concerns regarding the service?
Where's the first place you'll go with your new set of extensions?
Thank you!
