Hair extension consultation form by Dreisy Figueroa

First Name

Last Name

Phone *

Email *

Gender

Male

Female

Other

Occupation

Emergency Contact Name

Emergency Contact Phone Number

Medical History

Have you been pregnant in the last 6 month?

Yes

Have you ever suffered from hair loss?

Yes

Have you ever been diagnosed with alopecia?

Yes

Do you take any medications?

Yes

List any medications you take regularly including vitamins, aspirin. herbal supplements:

Do you suffer from psoriasis to the scalp?

Yes

Do you have a sensitive scalp?

Yes

Any other conditions?

Diagnostic Test:

Do you wear protective styles?. Braids, wig, etc

Yes

How often do you wash your hair?

How many times a week do you do a high pony?

Do you use hair products? Please name then:

How frequently do you go swimming?

Do you frequently go to the gym?

Yes

Do you blow dry your hair?

Yes, often

Yes, but not often

Do you currently color your hair?

Yes, Salon color

Yes, Home color

Have you used hair extensions before?

Yes

Name the method used:

How long have you used hair extensions in the past?

Did you like them?

My hair is:

Straight

Wavy

Curly

Coily

Scalp is:

Oily

Dandruff

Dry

Normal

Hair Length:

Above shoulder

Below shoulder

VERY IMPORTANT* Photo Uploads

PLEASE READ THIS SECTION BEFORE SUBMITTING PHOTOS. This section is required to reserve an appointment. Please closely read and follow guidelines so I can accurately give you a price quote. Even if you have extensions currently installed, please still submit the required photos with your current hair. I will be unable to give price quote if these photos are not uploaded according to the requirements * Almost there! I will need a few pictures of your hair taken in good lighting. These photos are required since l use them to not only customize your hair extensions but to also give you a customized price quote. It works best to have someone else take the photos if possible. I will need a current front, back and side picture of your hair. I also added space for you to leave 2 inspiration photos. I would love to know what your hair goals are. This means the color, length and thickness you desire. Let's get you your dream hair! *** If you are having difficulty uploading photos due to photo size direct message me on instagram @sinfulbeautybyd

Front Picture

Back Picture

Right Side Picture

Left side Picture

Inspiration Picture 1

Inspiration Picture 2

By signing below, you agree to the following: I have completed this form truthfully and to the best of my knowledge. I agree to inform the technician of any changes in the above information. I agree to waive all liabilities toward my technician and the employer for any injury or damages incurred due to any misrepresentation.

Signature

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CANCELLATION POLICY

Cancelation Policy

Our goal is to provide quality care in a timely manner. In order to do so, we have had to implement an appointment/cancellation policy.

Appointments are in high demand, and your early cancellation will give another person the opportunity to have access to timely care. This policy enables us to better utilize available appointments for our clients.

At the time of booking your appointment you will be asked to pay a $100 deposit that will be credited towards your service.

Time has been specifically reserved for your appointment, procedure, or treatment. If you need to cancel or reschedule your appointment you must call at least 24 hours prior to your appointment and your deposit will either be refunded or pushed for a future appointment. Providing less than 24 hours' notice you will loose your deposit as cancellation fee.

If you arrive more than 15 minutes late for your appointment it is considered a no-show and you will be charged the cancellation fee.

We are happy to answer any questions regarding this cancellation policy.

I have read and fully understand the above Appointment Cancellation Policy and agree to be bound by it's terms. I agree to pay the cancellation fee in the event of a missed appointment.

AGREEMENT FORM

Full Name

hereby give my consent to the stylist Dreisy Figueroa to perform the following hairstyling service on me:

HAIR EXTENSIONS SERVICE

1. Hair Changes:

I agree not to make any changes to my hair color, length, or texture between my consultation and installation appointments. I understand that if changes are made without approval:

• A second consultation will be required.

• If new hair must be ordered, a second non-refundable deposit will be required.

2. Deposit and Payments:

I understand and agree that:

• A 100 deposit due at the time of booking my installation appointment.

• This deposit is non-refundable under any circumstances.

• The remaining balance is due on the day of my installation appointment.

3. Maintenance Commitment:

• I commit to regular maintenance every week

• I understand that failure to attend maintenance appointments may result in permanent damage to my natural hair and/or extensions.

• I acknowledge that I am responsible for scheduling my maintenance appointments in advance.

• I understand there will be additional costs if maintenance is delayed beyond the recommended timeline.

• I agree that the stylist, Dreisy Figueroa, is not responsible for any damage caused by my negligence.

4. Medical and Health Conditions:

I confirm that I have fully and completely informed Dreisy Figueroa of any and all medical conditions, allergies, or other health-related information that may impact the hairstyling services being provided.

5. Cancellations and Modifications:

I agree to give my stylist at least 24 hours notice if I need to cancel or reschedule my appointment. I understand that failure to provide sufficient notice will result in me being charged the full price of the missed service.

6. Liability Waiver:

I agree to hold Dreisy Figueroa harmless from any and all liability related to the hairstyling services provided.

By signing below, I confirm that: • I am over 18 years of age and consent to this agreement and the hair extensions service. • I have completed this form truthfully and to the best of my knowledge. • I have been given the opportunity to ask any and all questions regarding this procedure, and all questions have been answered to my full satisfaction. • I acknowledge and agree to all terms outlined above.

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Consent Form Signature

Pick your service

Non refundable deposit required