Digital Consulation

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What is your name?* This field is required.
First Name
Last Name
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It is so nice to meet you, Love!
Thank you for taking the time to complete the new guest profile. This will help me to guarantee the best possible experience for you today and for all future visits. I will keep this securely in your online client file and it will not be shared with any one else.
I want to hear it all!! To get started, tell me a few things about yourself. We will also have a formal consultation in person! This will just help me better understand you, who you are, and how to appropriately book you!
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What is your Instagram Handle?
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What were you looking to get done?* This field is required.
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Tell me about your current hair routine ? * This field is required.What products do you like to use? What hair tools do you often use? Do use a lot of heat on your hair? Do you use any proteins?
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Tell me about what you LOVE about your current hair.
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Now can you tell me about what you don't love and what you would want to make better ...
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Tell me about your ultimate hair goals! What would you love for your hair to be like ?
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How would you describe your hair to be ?Kindly, select all that applies.
Fine/ skinny
Extremely thick.
Virgin hair, I never colored it
Very long
Short
Past my shoulders
Pin straight
Wavy
Curly
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How often would you like to come to the salon to maintain your new look?You can pick a few options
every 3-4 weeks.. I have a lot of gray!
4-6 weeks
2-3 months; seasonly
5-6 months
once a year
Weekly blowouts
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Have you ever had an adverse reaction to hair color?
YESNO
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What was the last chemical process?Did you have your color done professionally? What color was it ? Have you done any keratins, Brazilian Blowouts, Perms? If so, when? Have you done any dyes yourself at home?
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When is the last time you had your hair cut?
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Do you need gray coverage?
Nope.
Yes, HELP!
Not really, I just have random grays. Im not crazy concerned about it, but I would still appreciate your advice.
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WE'RE ALMOST THERE!
Follow the instructions below and show me some photos of your current hair AND some inspiration photos on the next steps.
These photos will help me understand the current state of your hair. This will save time for both you and me and will help me book your appointment correctly!
Don't be nervous! I don't need to see your face, just your hair! Feel free to put an emoji over your face if you're not comfortable. This is solely to see your current hair.
• Must be photos of your current hair.
• Use your cell phone.
• It's way easier if someone else takes the photo for you, but you can also set your timer and take a step back to ensure ALL of your hair is in the photo.
• Take in natural lighting (no flashes, please).
• You will take two-/three photos - Front, back, and side (side is optional but appreciated).

Alternatively, you can text me your full name and these photos at (732) 508-0088 after you have completed this form. If you are busy at work or cant send me these photos at the moment, save this number and send them at your earliest convenience.
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Please submit the BACK and FRONT photos of current hair
Drag and drop files here
Select files to upload
Cancelof
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Please submit the pictures of your SIDES of current hair
Drag and drop files here
Select files to upload
Cancelof
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Please submit the DESIRED LOOK/INSPIRATIONAL photo.
Drag and drop files here
Select files to upload
Cancelof
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Thank you!! I just need to gather some information to make any future appointments. What is your address?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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What is your Email?* This field is required.
example@example.com
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What is you phone number?
Area Code
Phone Number
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What is the month and date of your birthday? This is for birthday rewards!
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How would you prefer to be contacted for any future appointments?Where should the booking system send you reminders?
Email
Text
Email and Text
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What days and times work best for you?* This field is required.My in-salon hours: Tuesday 10-8, Thursday 10-8, Friday 11-6, E/O Sunday 10-3. Please give me 3 preferred dates at least 2 weeks out, along with days and times that you typically available.
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Did anyone recommend you? I would love to send them a THANK YOU.
26
Have you been to this salon before? * This field is required.Select an answer from the drop down menu.
I have been to Bellarocooco Salon
You have done my hair in the past
Neither, I am a new guest!
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Please review this information.

This is what I'll use to create your customer account. If you see a typo, please correct it above.

Name: {whatIs}
Address:

Email: {Few}

Phone Number: {whatIs19}

Birthday: {whatIs40}
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SERVICE RE-DO & RETAIL RETURN POLICY: I strive to offer my guests the highest level of guest satisfaction. If you are having challenges with your cut or color, let me know within 7 days of your visit and I'm happy to correct the issue with no additional charge. Should you make a retail purchase that you are unsatisfied with, I will accept retail exchanges at full credit for 14 days from your initial purchase. Please select below if you agree to these terms and would like to continue with services today.* This field is required.
Agree
Disagree
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By completing this form, I am submitting an appointment request and price quote inquiry. In response, I will receive an email/text with an appointment time and date option and a general price quote. Your appointment in the salon will begin with a 15-minute full consultation to refine the plan for service. (Generally, new guests are able to be seen within 2-3 weeks of appointment submission request, but guests with limited availability may have to wait up to 12 weeks to be seen.) I understand that there is a strict 24-hour cancellation policy. Should I cancel my appointment with less than 24 hours' notice, a $25 per service canceled fee will be charged will be due before a new appointment is scheduled. If I do cancel my appointment with less than 24 hours' notice, I may be banned from booking future appointments with the salon. By clicking the submit button below, I agree to these terms.
AgreeDisagree
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