Healthy Hair Extensions Consultation Request Form
Q.1
Please enter your name
*
Title
First Name
Last Name
Q.2
Please enter your email address
*
(e.g. john@example.com)
Q.3
Please enter your Phone # and your preferred contact method (email or telephone)
Q.4
What hair extension method are you interested in?
Keratip
Mini Illusions (Micro Links)
Flash Point (Shrinkies)
Custom Clip Ins
Micro Weft Links
Q.5
What is your preferred Consultation Method?
In person ( If yes, please enter available times for consultation in question 5)
By Email ( If yes, please email healthyhairextensions@gmail.com with a recent photo front & back view)
Q.6
When is your 1st Choice Consultation Time ? (Consultations last 20 minutes)
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Q.7
When is your 2nd Choice Consultation Time?
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Q.8
When is your 1st Choice Appointment Time (Please allow 4-5 hours for appts.)
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Q.9
When is your 2nd Choice Appointment Time?
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Q.10
If you are interested in Mobile Services ($100 surcharge) please enter your address
Address Line 1
Address Line 2
City
State
Zip Code