New Guest Questionnaire

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number
Area Code
Phone Number
4
City, State
5
How'd you find Roxy Bunce?
Instagram
Facebook
Google
Yelp
Local Business
Met in Person
Referral from Friend
Social Media
6
What's the name of your friend who referred you?
7
Are you ONLY looking to book a haircut?Currently do not accept any new "Haircut Only" guests. You must be getting a color done with your service in order to receive a haircut/appointment.
YESNO
8
At this time, Roxy is not accepting new Haircut Only guests. If you feel this may be a mistake, please email Roxy directly at roxy.hair@gmail.com. If you'd like to get a color done, please continue with the application.

All color packages include a haircut and start at $200+
9
Check off all of the services you think you might need.
Grey Coverage
Balayage
Highlights
All Over Lightening
All Over Darkening
Haircut
Color Correction
Shadow Root
Lowlights
Conditioning Treatment
Product Recommendations
Toner
Styling Lessons
Other
10
Image Field
11
Based upon Roxy's Service Menu, what Service Package are you thinking you may need?
The Revamp $200+
The Works $400+
The Transformation $240+
Other
12
Hair Density Examples
13
How would you describe your hair density/thickness?
Extra Light
Light
Light - Medium
Medium
Medium Heavy
Heavy
14
Hair Length Chart
15
In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?
Short
Medium
Long
Extra Long
16
Your hair history within the last 3+ years.
I have colored my own hair.
I have not colored my hair in 3+ years.
I have gotten my hair colored professionally.
Other
17
What hair color/product did you use? Please Check all that apply.
From Sally's Beauty Supply
From Online
From Drugstore/Grocery Store
Box Dye
Splat
Overtone
Temporary Hair Color Rinse
Other
18
Please upload 2 pictures of your current hair (front and back) in natural lighting.* This field is required.Avoid direct sunlight or dark rooms.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
19
Please share 2-3 Inspiration Pictures.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
20
What are you looking to get done? Is there anything else you'd like to share?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: