Free Hair Consultation

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I offer a free 15 minute consultation. The first step would be to fill out the form below. This will help me understand your hair better. Once I review this I will be in touch to schedule a time for you to come in!

Name*
First Last
Email*
Phone
What is your current hair length?*
How would you describe your scalp?*
Current condition of your hair*
Shampoo frequency*
Density of your hair*
Do you have problem with dandruff?*
Are you taking any medication that has side effects which can cause hair thinning and/or hair loss?*
Which One*
- Breaking
- Shedding
- Flaking
- Itching
- Other
Do you have now, or have had in the past, any problems with hair loss?*
Can you tell me more?*
Would you like to send a current [close-up] picture of your hair?*
Photo Upload
Drop files here or
Max. file size: 512 MB.
Desired Service(s)
- Balayage
- Blow Outs
- Conditioning
- Extensions
- Haircut
- Highlights
- Root Color
- Toning / Glossing
Is there any additional information you would like to share about your hair?
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949-415-4744
email@hairbyfalisha.com

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