Guest Intake Form
Please fill out this form and I will be in touch to schedule your consultation. In your consultation, we will go into detail about your hair and discuss our plan to reach your hair goals.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
How did you hear about me?
*
Please Select
Social Media
Internet
A Friend
Other (Please specify...)
When is your Birthday? Month/Day
*
Are you looking to change or refresh your current color?
*
Please Select
Yes, I need a complete change, it's been a while since I've done anything.
Yes, I need a little refresh, but something similar to what I currently have.
No, I like my current color, I just want it touched up, no major changes.
What services do you generally receive currently? (Select all that apply)
*
Haircut
Deep Conditioning Treatment
Smoothing Treatment
Hair Extensions
Grey Coverage Hair Color
All over Hair Color, without any Grey Coverage
Highlights
Lowlights
Balayage Blonding
Please Select which one best describes the current condition of your hair.
*
Very Healthy
Healthy, with some minor split ends or dryness
Mildly comprimised, a little fragile from color/highlight processing
Over processed/broken
Have you ever had an adverse reaction to hair color?
*
Yes
No
What day are are you best available? Select all that apply.
*
Tuesday
Wednesday
Thursday
Friday
Saturday
What time of day are you best available? Select all that apply.
*
Morning 9am - 12pm
Afternoon 12pm-4pm
Evening 4pm - 7pm
FUTURE APPOINTMENT CANCELLATION POLICY: In order to provide the best experience for all of my guests I ask that you please accept my cancellation policy. I understand emergencies happen, last minute things come up. I ask that you please be respectful of my time and give me a 48 hour notice if you need to cancel an appointment. If I'm not given proper notice I will require a payment of $50 per service scheduled. Thank you for understanding.
*
Please Select
I accept the terms of the cancellation policy.
Submit
Should be Empty: