Booking Request

1
Full Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Instagram Account
ex. @hairbystacilynn
4
Phone Number* This field is required.
5
Birth Date
Month
Day
Year
6
What days of the week work best for you?* This field is required.
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
7
What service are you wanting done?
Haircut
Custom Haircolor
Scalp Facial
8
Please upload a photo of your current hairIf booking for a hair color
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
9
Please upload an inspiration photoIf booking for a hair color
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
Describe your dream hair. (what you like & don't like)
11
How often do you go to salon?
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
12
Can you tell me about your color history for the past 2 years.* This field is required.
13
Where did you hear about me?
Facebook
Instagram
Google Search
Referred by a friend
Other
14
Any questions/concerns?
15
Cancelation Policy* This field is required.I understand life happens and emergencies pop up ,but I kindly request the respect of my time and the time of others by requiring a 24-48 hr. notice of any changes to your appointment.Failure to provide notice in time will result in a charge of up to 50% of the service scheduled for. If for some reason you are expecting to be10-15 minutes late to your appointment, please call or text ASAP. Be aware that arriving 15+ minutes late will be considered a no show and subject to a fee up to 100% of scheduled service.
16
Client's Signature* This field is required.
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