Wild Roots Hair Lounge

New Client Intake Form For Extension and Hair Transformation Services

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Digital Hair Extension Consultation
What date would you prefer for your extension consultation or service? (required)
Have you worn hair extensions before? (required)
What type of hair extensions are you interested in?
What are your main goals for getting hair extensions? (required)
Are you looking to get color, extensions or both? Please describe (required)
Approx how tall are you (required)
What length are you hoping to achieve? (required)
What best describes your current hair length? (required)
What best describes your current hair density? (required)
What best describes your natural hair texture? (required)
What texture or daily wear style are you going for?
Please describe your current hair color, including any highlights, balayage, lowlights, or vivid colors. (required)
Upload a clear photo of your current hair from the front in natural lighting. (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Upload a clear photo of the back of your current hair down, in natural lighting. (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Upload any inspiration photos showing your desired extension look. Upload color, length ,and style inspo. (required)
JPG or PNG. We’ll upload it with your response. Selected — tap change to pick another.
Hair History. Well water, allergies, adverse experiences, color history, medication/illnesses, etc.
Please describe any color, chemical, or smoothing services you have had in the last 12 months. (required)
Have you experienced significant hair loss, excessive shedding, or thinning recently? (required)
If you have experienced hair loss, shedding, or thinning, please explain. (required)
Do you currently have any scalp concerns? (required)
Are you currently pregnant, postpartum, or experiencing hormonal changes that may affect your hair? (required)
Lifestyle and Maintenance
Which activities are part of your regular routine? (required)
How often do you wash your hair? (required)
How often do you heat style your hair? (required)
Are you willing to follow a professional home care routine for your extensions? (required)
Are you willing to schedule regular maintenance appointments as recommended? (required)
Budget and Expectations
What is your estimated yet firm budget for the initial extension installation, including hair and/or color services? (required)
What is your preferred maintenance budget per appointment? (required)
Is there anything specific you do not want with your extension or color result? (required)
Do you have any upcoming events, travel, or deadlines we should consider when planning your service? (required)
What do you like about your current hair and hair salon experience? (required)
What do you not like about your current hair and current hair salon experience? (required)
Final step
Your contact details
We’ll use this to attach your responses.