Luscious Looks - Online consultation form

If you are interested in having hair extensions you're welcome to fill out this online consultation form. It takes a few minutes and goes through some of the details that are covered in a face-to-face consultation, it doesn't replace it but allows me to assess your hair suitability quickly and then get back to you within 24 hours.

Contact Details
Your Name :		Home Phone :
Address :		Mobile :
		Email :
		Confirm Email :
PostCode :		How did you hear about Luscious Looks? :

Have you had hair extensions before?	Yes No
If yes, which type have you had?
Have you ever suffered from hair loss/Alopecia?	Yes No
Have you ever had Chemotherapy?	Yes No
Are you taking any medications that can affect hair growth?	Yes No
Are you pregnant or had a child in the past 6 months?	Yes No
Do you suffer any sensitivities or allergies?	Yes No
Currently, how is your natural hair?	Natural Permed Tinted Bleached

Please tick all options that describe the condition of your natural hair?

Dry Weak Damaged Greasy Coloured

Please describe the thickness of your natural hair?	Is your hair longer than 4 or 5 inches?
Thin Medium Thick	Yes No
What colour is your natural hair?

What extensions method are you interested in?
0.5 g Pre-Bonded Extensions	1 g Pre-Bonded Extensions
Micro Ring Extensions	Pre-Taped Weft

What length are you interested in?

14 inch 16 inch 18 inch

Any further comments / queries?

I do certify that the above information I have provided is correct to my knowledge and that I have read the aftercare section of the website, I also agree to carry out all of the advice given to me by this and by you, the stylist.
I will not hold the stylist responsible for any damage caused by myself for failing to carry out the information and instructions given to me or for supplying any incorrect information at any time.
I understand that regular maintenance is required to keep my extensions at their best and removal must be carried out after 3 - 4 months by myself or another professionally trained stylist.

Please tick the box below to confirm you have read and understood the information above.

Finally just some anti-robot submission protection.
Please copy the number sequence in the black box into the white box to verify you are human

Contact Details