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        5)  Hair Color Base _________________________                                   
             Base color plus one highlight are NO Extra Charge.
             Additional highlights add $20 each.

             If choosing color from our color ring, please indicate
             color number.  (For a color ring please call us at:  203-724-5825)

             If you are sending us a sample of the base hair color you would
             like us to match for you, please write in the space above,
             "Complimentary Color Match".  All samples must be 1" long and 1/4"
             wide.  Tape the hair sample at one end with scotch tape, and label
             "Base Color Sample", and don't forget to add your name.

        5A) Highlight Color #1 ______________________
              If choosing color from our color ring, please indicate color number.
              (For a color ring please call us at:  203-724-5825).

             If you are sending us a sample of the base hair color you would
             like us to match for you, please write in the space above,
             "Complimentary Color Match".  All samples must be 1" long and 1/4"
             wide.  Tape the hair sample at one end with scotch tape, and label
             "Highlight #1 Color Sample", and don't forget to add your name.

             Even blending of base & highlight #1 Colors (50%-50%) _____________
             Streaked 70% Base Color & 30% highlight #1 Color (70%-30%) __________
             Other:  __________________________________________________________


        5B) Highlight Color #2 ______________________
              If choosing color from our color ring, please indicate color number.
              (For a color ring please call us at:  203-724-5825).

             If you are sending us a sample of the base hair color you would
             like us to match for you, please write in the space above,
             "Complimentary Color Match".  All samples must be 1" long and 1/4"
             wide.  Tape the hair sample at one end with scotch tape, and label
             "Highlight #2 Color Sample", and don't forget to add your name.

             Even blending of base & highlight #1&2 Colors (50%-50%) _____________
             Streaked 70% Base Color & 30% highlights #1&2 Color (70%-30%) __________
             Other:  ___________________________________________________      Extra Charge: $__________

                           
        6)  Photos- Please send us the following photos by mail or email (you can take these yourself):

                      Direct Front with hair pushed off your forehead so we can see your hairline as it is now
                      Direct Front with hair as you currently wear it
                      Right Side
                      Left Side
                      Direct Back
                      Direct Top
                      1 Photo of Each area you have hair thinning or loss
                         that you want addressed with your blending enhancement.

          7)  Measurements - Please write them in inches: 
               Please use a soft measuring tape and hold the tape firmly creating a snug yet comfortable
               feel when taking measurements.  Your measurements are a critical factor in creating your
               custom blending enhancement, so please take the time to ensure accuracy, even if you
               have to take the measurements several times just to be sure.

               If you have questions or need help in the measurement process, please call us at: 
                   203-724-5825.  We will be happy to talk you through the process.

        8)  Please indicate where on your head you'd like to camouflage hair loss/thinning:
             _________________________________________________________________________
             _________________________________________________________________________
             _________________________________________________________________________

        9)  Are you ordering the hair blending enhancement for (please check all that apply):

             Overall volume ______                       Overall volume & length________

             Overall length  ______                       Hair loss/thinning ________

      10)  If you are experiencing hair loss or thinning, do you expect the hair thinning or loss to

             continue in the same area within the next 12 months?

             ______Yes                  ______No

      11)  Do you expect the hair thinning or loss to spread to other areas of the scalp within the next 12

             months?

             ______ Yes                  ______No

Additonal Comments/Instructions:  _________________________________________________________________
_________________________________________________________________
_________________________________________________________________

Total up the base charge and all additional charges:                                 Sub-Total: $____________

                                   ________  Credit Card (please fill in authorization below)

Note:  Please be sure your measurements and ALL information on this order sheet are correct.  Custom blending enhancement orders cannot be cancelled once in production, nor can they be returned once shipped out, unless an order error occurred on our part, in which case we will fix it in a timely manner.  There are no refunds - NO EXCEPTIONS.  This is due to the fact that each blending enhancement is custom made and requires over 200 hours of work which the hair studio charges us for.  Your blending enhancement should be treated with care.  Do not allow harsh detergents, chemicals, dyes, relaxers, etc., to get on the enhancement base.  And like your own hair if you pull on the blending enhancement hair hard enough, it will come out, and even though the base net is made of a sturdy and strong fiber, if you are rough with it, keep pulling on it, or yank on or keep catching the holes with a comb or styling tool, it can break or become damaged.  Often times, we can fix it for you depending on the severity of the damage, but you will be charged extra for this service and it will take a few weeks for the work to be done.   Also, if you gave the wrong measurements, chose the wrong density, colors, texture, etc. and want us to correct the mistake, you will be charged extra for any of these services.  By submitting your order, you understand that in the event you decide you don't like the product, it isn't what you thought it would be, you didn't understand how the product worked, etc., you will not be issued a refund.  However, if an error occured on our part, we will fix it, if you inform us within 24 hours of receipt of your order.  We will work hard to make you a happy customer, but within reason.  By submitting your order you agree that you waive your right to file a a credit card charge back with your bank, or put a stop payment on a check or money order you have issued to us as payment, for any reason.  All disputes must be handled via our binding mediation team.  Additionally, you affirm that you have thorougly read and understand and agree to the polices set forth on our website at www.dreamhairblending.com.

** Please ensure that all photos and/or samples are sent to us at the address at the top of this order form with your name and phone number.  You can include your order form, or fax the order form and credit card authorization to our secure fax line at:  845-698-2349.  An order confirmation will be sent to you via email within 24 hours of receiving your order.                                     

Delivery Time:    Since each blending enhancement is custom made, the normal delivery time is between 5-7 weeks.   On occasion it may take a little longer, but it is worth the wait to be sure.  We ship your blending enhancement to you via Fed Ex/UPS or USPS, free of charge within the United States.

Agreed & Accepted By:

________________________ (Sign Name)

Print Name:  _______________________
Date:  _____________________________

                                                    
                                                                                                                                Credit Card Authorization

I hereby authorize Dream Hair to charge my credit card for the deposit of 50% of my order at this time, and the remaining balance which is due plus tax (CT residents) and payable at the time of shipping.  I understand that I am bound by the terms indicated on this order form, and hereby agree to them.  I understand this product is entirely custom made and is not returnable.  Deposits will be retained to cover costs in the even of order cancellation by me.

Credit Card:        _______ Amex     _______MC    _______Visa        _______Discover

Name As It Appears On Credit Card:    ____________________________________
Billing Address:  ______________________________________________
                      ______________________________________________
                      ______________________________________________

Telephone:  ___________________________________

Credit Card #: ______________________________________
Expiration Date:  _________________________________
Security Code:   _______________________   (last 3 numbers shown on strip on back of card)


____________________________________
Card Holder's Signature

Privacy Statement

Dream Hair never shares any of your information with an outside 3rd party.  Your privacy is very important to us, as it is to you, and we won't compromise the trust you have placed in us.