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Asante Salon Redmond Town Center
7425 166th Ave NE, Ste C-237
Redmond, WA 98052

Online Consultation Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Preferred Method of Contact(Required)

Phone

Text

What is your reason for seeking our services? (Check all that apply)(Required)

Thinning Hair

Hair Loss

Alopecia

Cancer

Other:

What is your reason for seeking our services? (Other)

Have you used wigs, toppers, or extensions before?(Required)

Yes

Which solution are you most interested in learning more about?(Required)

Wigs

Hair Toppers

Hair Extensions

Not Sure Yet

Would you prefer an in-person or virtual consultation?(Required)

In-Person (Private Room)

Virtual (Video Call)

How soon are you looking to schedule your consultation?(Required)

As soon as possible

Within the next week

Within the next month

Just gathering information for now

Is there anything you'd like us to know before your consultation?

To help us better understand your needs, you may upload a current photo of your hair or scalp (this is optional and confidential).

Accepted file types: jpeg, jpg, png, gif, webp, pdf, tiff, heic, Max. file size: 50 MB.

Consent(Required)

I understand this is a private and confidential consultation and agree to be contacted by Asante Salon for scheduling.

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