First Name Last Name
Your email address (i.e. hairgoddess@dollywood.com):
E-mail
How did you hear about us?
Pitch Weekly The Internet KCStar.com On the radio From a friend SBC Yellow Pages
Is your goal to add new
Hair length Hair volume
Please tell us about the density of your hair. Is it:
Light density Normal density Heavy density
Check this box if your hair balding or thinning in spots?
Tell us about your hair texture. Is it:
Fine Normal Coarse
What about your curl pattern? Is it:
Straight Slightly wavy Curly Very curly
Check here if you have ever worn extensions before?
Do you chemically treat your hair (at home or at the salon) with:
Color Highlights Other chemical treatments
Check this box if hair at least 4 inches at the crown and on the sides?
About how often do you visit your current salon?
Weekly Once a month Four times or less a year
