Pre consultation form

Pre-Consultation

Thank you for taking a few moments to fill out this form. This will help give us a better idea of what your hair color goals are and how we can get you to those goals. Once completed our staff will contact you, please allow 24-48 hours
Date

MonthDayYear
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
Please enter a valid email
How did you hear about us?
How would you like us to contact you?
Which services are you interested in?

Check all days/times that work for you? (Assuming first time color appointment varies from 2-4 hours on average)

Please upload a current picture of your hair. Indirect lighting is best front and back if possible. *

Current Picture
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Please upload an inspiration/goal picture.*

Goal Picture
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When was your last color?

1-2 months ago3-4 months ago4-6 months ago7+ monthsOther
How long has it been since you last used over the counter "box" dye?

Never3 months6 months12+monthsOther
How would you describe your hair? Name as many as you'd like.

ShortMediumLongFineThickCoarseCurlyDullDryLimp/flatHealthyDamagedOther
Have you had any of the following; bleach, corrective color, or perm/ relaxer or henna within the past two years?
Have you had a keratin treatment in the last year?
Do you have well water at home or at school?
Do you have any allergies we should be aware of?
To the best of my knowledge, I am not showing any signs of sickness including: cough, fever, tiredness, difficulty breathing.
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Pre-Consultation