If you are interested in booking  an appointment for the application of Hair Extensions please fill out the following form.  We will assess your suitability for Hair Extensions and get back to you within 24 hours.  During this call we will review your consultation form with you and schedule a face to face free consultation. If you wish to go ahead with the Hair Extension service you can check availability and book online using our online appointment system.  We will require a $50 deposit before we can confirm any appointments.  Give us a call at 916-242-9939 to leave your deposit.   Try to  answer the questions as accurately as possible,  if we find your hair to be in too poor condition when you arrive for application of the extensions, we will provide you with a more suitable application method for your hair condition. 

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* Required fields
Name *
E-mail Address *
Phone *
How did your heard about Hair Addictions? *
Have you ever had hair extensions before? *	Yes No
If yes, which type of hair extensions did you have?
Did they meet your expectations? If not, why?
Have you ever experienced hair loss or damage to your natural hair? *	Yes No
Do you now, or have you in the pass had alopecia? *	Yes No
Have you ever undergone any chemotherapy treatment? *	Yes No
Are you on any medication that lists hair loss as a side effect? *	Yes No
Are you pregnant? *	Yes No
Have you been pregnant in the past year? *	Yes No
Have you got a sensitive scalp or skin? *	Yes No
Are you allergic or sensitive to any hair related product? *	Yes No
Have you had major surgery within the last 6 months? *	Yes No
If so, What products
Is you hair currently? *	Permed Relaxed Colored Texturized Natural (no chemicals)
Please check all options that describe the condition of your natural hair *	Dry Damaged Weak Greasy Healthy Strong Colored
Please describe the texture of your natural hair *	Chemically relaxed Medium curl Straight Natural wave/body Very curly Wavy Curly
Please describe the thickness of your natural hair *	Thin Medium Thick Extremelly Thick
Does you mother or father have thinning or advanced hair loss? *	Yes No
Is your hair longer than 3-4 inches in length? *	Yes No
Please describe the colour of your hair at present *
Do you require extensions for length or thickness? *
What method of application do you require? *	Pre Bonded Hair/ Fusion Micro Ring Pre Bonded Micro Ring Weft Express Extensions/ Bonding Express Extensions/ Tape Malaysian Weft Braided/ cornrow weft Other I am not sure
*What length do you require? *	10 inch 12 inch 14 inch 16 inch 18 inch 20 inch 22 inchs or more I do not know
What do you want to do? *	Add length Add length & fullness Add highlights Add fantasy colors Add low lights Fill in sides and/or areas
How long do you want your extensions to be? *	Above shoulders Waist Mid-back Past shoulders
*Please state your requested date/time for fitting *
Any further comments/queries:
Best time of day to call *

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Hair Addictions Design Studio 6839 Five Star Blvd. Suite E,  Rocklin, Ca 95677

916-242-9939