RWS Appointment Request Form

1

NAME

First Name

Last Name

2

PHONE NUMBER

Please enter a valid phone number

3

HOW DID YOU HEAR ABOUT ME?Referral (client name), Social Media (IG, FB), Google Search, etc.

4

GENDER

FEMALE

MALE

5

SERVICE TYPE

6

WITHIN THE LAST 6 MONTHS, DO YOU HAVE ANY OF THE FOLLOWING?Please check all that apply

PERMANENT HAIR COLOR

BOX DYED COLOR

SCALP CONDITIONS

SUFFERED MAJOR HAIRLOSS

NONE OF THESE APPLY

8

APPOINTMENT PREFERREDNot guaranteed TIMEFRAME

ASAP

1-2 WEEKS

1-2 MONTHS

FLEXIBLE

9

SHOW ME YOUR CURRENT HAIR

• Use your cell phone
• Take 2 photos of your current hair down, (one front view and one back view)
• Take in natural lighting indoors (no flashes or direct sunlight)
• Hair down
• No filters

Please make sure to include photos

10

UPLOAD FRONT VIEW PHOTO HEREHair down, no filter, natural lighting

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

11

UPLOAD BACK VIEW PHOTO HEREHair down, no filter, natural lighting

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

HAIR GOALSNow show me your dream hair. What is your inspiration for your hair color today? Upload as many photos as you’d like.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB