Hair Extensions Consultation & Consent Form

Client Name:** _____________________________   
Date:** ______________________

Phone Number:** ________________________   
Email Address:** ___________________________

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### Hair and Scalp Analysis:

- **Hair Type:** ☐ Fine ☐ Medium ☐ Thick  
- **Texture:** ☐ Straight ☐ Wavy ☐ Curly
- **Scalp Condition:** ☐ Healthy ☐ Sensitive ☐ Other: ________________
- **Hair Condition:** ☐ Excellent ☐ Good ☐ Moderate Damage ☐ Severe Damage

### Extension Goals:
- Desired Length: ___________________
- Desired Volume: ___________________
- Desired Color(s): ___________________
- Specific Concerns: ___________________

### Lifestyle & Maintenance:
- Frequency of hair washes per week: _______
- Regular exercise/swimming: ☐ Yes ☐ No
- Daily styling habits (heat styling, etc.): ___________________________
- Previous extensions experience: ☐ Yes ☐ No

### Allergy & Sensitivity Test:
- Patch test performed on (date): _______________
- Reaction noted: ☐ No ☐ Yes (specify): ______________________

### Consultation Summary:
- Recommended extension type: ☐ Hand-Tied ☐ Genius Weft ☐ Flat Weft ☐ O-Tape ☐ Traditional
- Recommended method: ☐ Pro-Weft ☐ Natural Beaded Row ☐ No-Stitch ☐ Other: ____________
- Additional notes: ____________________________________________________

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### Consent & Agreement:
I understand that:

1. Proper maintenance, including recommended products and care, is necessary to ensure the longevity and appearance of my extensions.
2. Failure to adhere to provided aftercare instructions may result in hair damage or reduced lifespan of extensions.
3. Extensions require regular maintenance appointments, and I commit to attending recommended follow-ups.
4. Sensitivity, irritation, or reactions may occasionally occur, even after a successful patch test.
5. Extension installations may cause temporary discomfort or tension, which should subside within a few days. Persistent discomfort should be reported immediately.

By signing below, I acknowledge that I have fully disclosed all relevant hair and scalp history, have read and understood the provided information, and consent to proceed with the hair extension installation service.

**Client Signature:** _____________________________  
**Date:** ________________________

**Stylist Signature:** ____________________________   
**Date:** ________________________