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Hair Extension - Consultation
This form is for in salon consultations. Please use the contact form on the homepage for general enquiries.
First Name
Last Name
Email
Phone
Address
Postcode
DOB
How did you hear about us?
Please choose an option
Instagram
Word of mouth
Website
Other
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Do you give permission for your photos to be used on social media?
Please choose an option
Yes
No
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Instagram name
Please answer the following questions
Have you had hair extensions before?
Yes
No
If yes, did they meet your expectations?
Yes
No
N/A
Has your hair been tinted or highlighted before?
Yes
No
Have you suffered from Alopecia?
Yes
No
Are you on any medication that causes hair loss?
Yes
No
Are you having Chemotherapy?
Yes
No
Do you have a sensitive scalp?
Yes
No
Any Psoriasis or Dermatitis your scalp?
Yes
No
Any allergic reactions to Copper, Zinc or Latex?
Yes
No
Suffered hair loss/damage to own hair?
Yes
No
Have you been pregnant in the last 6 months?
Yes
No
Do you train in a Gym? Use a Sauna? Swim?
Yes
No
Are you interested in Payl8r? Payl8r is an external company that allows you to spread the cost over 3, 6 or 12 months with an interest rate between 1 and 4% depending on your credit rating, eligibility applicable.
Yes
No
Received a patch test
Yes
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All deposits are non refundable and in the case that appointment should be cancelled or rescheduled, the deposit will be added to your account as credit as long as any changes or cancellations have been made outside of a 48 hour window leading up to your appointment. If this should happen within that 48 hour window, then the deposit will be lost. Signing this means you adhere to these rules. I certify that all the information provided is correct and I agree to follow the aftercare instructions for my hair extensions and/or colour. I know that if I am to experience any unusual discomfort to my hair to contact my Hair Stylist or Hair Extensionist immediately. For new Hair Extensions we recommend that you use Sulphate Free Shampoo and a strong hair mask to keep your Extensions nourished. This should be used on weekly basis, along with hair oil and heat protection if heat is applied. You must read the After Care leaflet, paying special attention to what can make your hair extensions change colour as this is very important to understand. The Glam Shack Co hold no liability once the hair has been installed, although we are happy to advise and give free hair checks should there be any concern.
Read and understood.
Your Signature
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