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17
Questions
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Area Code
Phone Number
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4
How do you prefer to be reached to book your appointment?
Phone
Email
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5
How did you find us?
Facebook
Instagram
Yelp
Google
Friend
Another Client
In the neighborhood
Other
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6
Desired services
Please select all that applies.
Haircut
Highlights
Single Process
Balayage
Blow out
Creative Color
Double Process Blonde
Extensions
Updo
Makeup
Not Sure
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7
Tell us about your hair! Describe your hair type and texture. Example: long and thick, curly and fine, very short, etc.
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8
Chemicals used on your hair in the last year.
Select all that apply
Permanent color
Lightener (Bleach)
Gloss or glaze
Keratin Treatment
Henna or Vegetable Dye
Relaxer or Perm
Other
None
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9
Are you looking for a new look or to just maintain what you already have?
New look
Maintain
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10
When was your last professional haircut?
Within the last 3 months
3-6 months ago
6-12 months ago
1+ year ago
Never had haircut professionally
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11
When was your last professional hair color?
Within the last 3 months
3-6 months
6-12 months
1+ year
Never had professional color
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12
When was your last chemical service other than color?
Within the last 3 months
3-6 months
6-12 months
1+ years
Does not apply to me
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13
How often do you like to visit hair salons?
Every 2 weeks
Every 4-6 weeks
Every 3-4 months
Twice per year
Once per year
Hardly ever
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14
Your most worn styles.
Select up to 3
Natural and air dried
Blown out
Curled with an iron
Up in a bun, ponytail, other
Straight/flat ironed
Extensions
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15
Upload an inspiration picture of your desired hair.
*optional
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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16
Upload a picture of your current hair.
*optional
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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17
Do you have any specific concerns about your hair or a salon experience that you'd like us to know about?
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