New Client Consultation Form

Name*

First NameLast Name
Date of Birth *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Email*
Instagram handle:
Do you have well Water?*

YesNoNot Sure
How long is your hair?*

Above shouldersCollar boneArm pitMid-back (bra strap)Lower-back (below bra strap)
Hair Density*

FineMediumThick
What is your NATURAL hair color?*

Light BrownMedium BrownDark BrownBlackLight BlondeDark blondeStrawberry blonde/ Light CopperRed / AuburnGrey
What has been Applied to your hair in the last 1-3 years? (Please check all that apply, failure to disclose information can result in chemical reactions).*

Never colored (100% Virgin Hair)At Home Box ColorHighlights / BalayageHennaSalon professional ColorPerm/ Chemical StraightenerAll over bleach
When was the last time you had your hair done, and what was done to it? *
What is your hair goal? Please be specific (hair cut, color, style etc.)*
What is a realistic maintenance goal for you?*

6 weeks6-12 weeks3-6 months6-9 monthsOnce per year
What is the best way to contact you?*

InstagramEmailTextCall
Please list hair care products currently used?*
Preferred Artist: Mekayla is currently our only stylist accepting new color clients! Shes available MON/ WED & occasional SAT *
Please provide current hair photos taken in indirect, natural light (not in a bathroom) side, or front facing preferred. *
Please attach 1-3 hair inspiration pictures *
I understand professional services require at home maintenance, failure to use professional products or the use of excessive heat impacts the longevity of my color and health of my hair. I am committed to maintaining my cut/ color as recommended by my stylist. *

I Agree
I understand that not all services may be possible given previous color and condition of my hair.*

I Agree
I understand some results take multiple sessions.*

I Agree
I give consent to the use of photos or videos of myself and my hair being used on social media and other forms of marketing.*

I AgreeI DeclineI Agree if my face is not shown
Cancellation policy: I Understand that I am required to give a minimum of 48 hours notice of cancellation/ rescheduling otherwise I agree to pay a cancellation/ rescheduling fee of 30% of the starting price of the services reserved. I agree to pay the fee that is due on the day of my original appointment date. I understand if I no show, no call, I will pay for 100% of the services reserved and will not be booked again until payment is received.

Yes, I Agree
I have read and agree with the cancellation policy*

Yes
Please allow 1-3 business days for a response. I encourage all new guests to DM their preferred stylist on Instagram after submitting your form letting them know you’ve completed it and that your patiently waiting to book your future appointment! We can’t wait to meet you!

Instagram handles:

Rochelle: @rochelleshopeofficial

Kyah: @kyahs.beauty.portfolio

Mekayla: @hairbymekayla
Signature:*

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