Questionnaires

Name Full Postal Address Home Telephone Number Mobile Telephone Number Email Address How did you hear about Rhodes Hair Extensions' Have you had Hair Extensions before' Yes No If yes, which type of extensions have you had' Did they meet your expectations' if not, why' Have you ever experienced and hair loss or damage to your natural hair' 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 Is your natural hair currently' Permed Tinted Bleached Please tick all options that describe the condition of your natural hair : Dry Damaged Weak Greasy Healthy Strong Coloured Please describe the texture of your natural hair Straight Wavy Curly Please describe the thickness of your natural hair Thin Medium Thick Extremely Thick 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' -Select a choice- Length - Full head of extensions Volume - Half head of extensions What method of application do you require' - Select a choice- Pre Bonded Hair Micro Ring Weft Pre Taped Hair What length do you require' 16 inch 18 inch 20 inch Please state your requested date/time for fitting Do you require a mobile appointment or appointment at premises' Any further comments/queries: Please note, deposits are non refundable. I certify that the above information I have provided is correct and that i have read the 'Aftercare' leaflet, I also agree to carry out all of the advice given to me. I understand that correct Aftercare Products are essential and I am responsible for making sure these products and used at all times. I will not hold the stylist responsible for any damage or injury caused by me failing to carry out the information & instructions given to me or for supplying any incorrect information at any time. I understand that regular maintenance is required to keep my extensions at their best and removal must be carried out after 3 months by Rhodes Hair Extensions. Signature Date