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Tia Rotenberg

hair extensions

consultation form

Tia Rotenberg

hair extensions

consultation form

Folder: hair extensions

consultation form

Hair Extension

Consultation Form

Ready to achieve your dream hair? Fill out the form below and Tia will be in contact with the best method for your hair needs and goals.

Name *

First Name

Last Name

Phone

(###)

###

####

Email *

How did you hear about me?

Instagram

Facebook

Friend

Other

Have you worn extensions before?

Yes

No

If so, what kind/method?

What is your biggest concern with wearing extensions?

What are your reasons for wanting hair extensions?

What is your hair type?

Straight

Curly

Wavy

A mix of wavy/curly

A mix of wavy/straight

Tight coils

Is your hair longer than shoulder length?

Yes

No

Is your hair color treated?

Yes

No

Are you looking to change your hair color or stay with what you have?

Drastically change

Stay with what I have

Subtle change

What is your hair density?

Very thin

Somewhat thin

Medium

Thick

Very Thick

Is your scalp...

Oily

Normal

Dry

Do you have a sensitive scalp or skin?

Yes

No

What is your ideal styling routine?

Blow dry & style

Air dry & style

Air dry

Diffuse

Thank you!