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Order Form
Tricho Alopecia Solutions
Finest Hair Replacement & Hair Shop
Clients Name:
Adress:
Post code:
Phone:
Email:
System base type:
Attach photo?
Head Circumference in Inches:
Style below:
1Left Crown
2Right Crown
3Center Crown
4Left Part
5Right Part
6Center Part
7Pompadour Freestyle
All back / All front
Hair length:
Waves/Curls:
Straight:
*
Slightly wave:
*
Light wave:
*
Afro:
*
Tight afro:
*
Hair density:
low: L;
*
Medium: M;
*
Medium Heavy: MD;
*
Heavy: H;
*
Frontal Hairline:
*
Temples:
*
Crown:
*
Back:
*
Hair length:
Type of hair:
---
Asian
Far east
European
Afro
Afroamerican
*
Your Hair Ethnic Origin is:
*
Hair color:
Attach Sample?
Yes
No
Attach old hair system:
Yes
No
Highlights:
Baby hair in front:
Yes
No
Base color:
---
Transparent
beige
brown
light brown
dark brown
yellow
*
Any allergies?
Any allergies In special to polyurethane?
Special instructions:
Sign:
Date: