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New Request for Coloring Services
18
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Phone Number
*
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Please enter a valid phone number.
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3
Email
*
This field is required.
example@example.com
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4
What is the best way to contact you?
*
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Text
Email
Phone Call
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5
What is your birthday?
*
This field is required.
Gift giving is our love language!
-
Date
Year
Month
Day
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6
Is there a stylist that you prefer to see?
*
This field is required.
Please take a moment to visit our website and check out the "About Us" section. You'll find profiles of each stylist, detailing their specialties. If you're unsure or would like our experts to assist you in finding the right match, simply select "No Preference." We're here to make sure your salon visit is tailored to your needs and preferences.
Please Select
Alanna
Briley
Melanie
Courtney
Kelsie
Kristin
No Preference
Please Select
Please Select
Alanna
Briley
Melanie
Courtney
Kelsie
Kristin
No Preference
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7
What are you currently struggling with the most?
*
This field is required.
Finding my signature hair color
Finding my signature haircut
Dry hair
Chemical damage
Dry scalp
Hair loss or thinning hair
Frizzy hair
Lack of volume
Oily or greasy hair
Dandruff
Split ends
Dull hair or lack of shine
Heat damage
Gray hair
Styling my hair
Using products
Nothing, I’m happy with it!
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8
Please select ALL the services you may need
*
This field is required.
All Over Color + Haircut
All Over Color + Style
All Over Color + Makeover
Single Color Touch Up + Haircut
Single Color Touch Up + Style
Single Touch Up Express (NO BLOW DRY)
Mini Touch Up + Haircut
Mini Touch Up + Style
Mini Makeover
Mini Touch Up Express (NO BLOW DRY)
Partial Touch Up + Haircut
Partial Touch Up + Style
Partial Makeover
Partial Touch Up Express (NO BLOW DRY)
Full Touch Up + Haircut
Full Touch Up + Style
Full Makeover
Full Touch Up Express (NO BLOW DRY)
Shampoo + Style
Bang Trim
Color/Cut Consultation
Extension Consultation
Eyebrow Wax
Hair Care Treatments
Styling Lesson
Product Lesson
Other
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9
How often would you like to maintain your hair?
*
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Once every 2 weeks
Once every month
Once every 2 months
Once every 3 months
Once every 6 months
Once every 2 weeks
Once every month
Once every 2 months
Once every 3 months
Once every 6 months
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10
When was your last professional salon color service?
*
This field is required.
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
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11
When was your last in home color?
*
This field is required.
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
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12
Have you ever had a reaction to color?
*
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YES
NO
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13
Current Hair Uploads
*
This field is required.
Please upload 2 - 4 current pictures of your hair in the most natural lightening possible. No filters. Please note - all images uploaded are kept secure, confidential and private to A Signature Salon employees only. We require this to better understand how we can achieve your goals.
Drag and drop files here
Select files to upload
Browse Files
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14
Inspiration Hair Uploads
*
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Please upload any images that you LOVE and would like your hair to look like.
Drag and drop files here
Select files to upload
Browse Files
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15
What days and times are you available?
*
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Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
9am - 12pm
12pm - 4pm
After 4pm
I am flexible
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16
What is your budget for this appointment?
*
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Remember, first time transformational appointments tend to be higher priced than a maintenance or touch up appointment. We are happy to work with your budget to meet your goals efficiently, effectively, and with integrity.
$100 - $200
$200 - $300
$300 - $400
$400 - $500
$500 - $600
I have no budget, I just want to achieve my goal right away
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17
Is there anything else you’d like your stylist to know?
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Small
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Ok
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18
How did you hear about us or find us?
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