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...