New Guest Questionnaire 2022

1
First Name* This field is required.
2
Last Name* This field is required.
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
Area Code
Phone Number
5
City, State* This field is required.
6
How'd you find Leah Nakata?* This field is required.
Instagram
Facebook
Google
Yelp
Local Business
Met in Person
Referral from Friend
Social Media
7
What's the name of your friend who referred you?
8
Are you ONLY looking to book a haircut?I currently do not accept any new "Haircut Only" guests. You must be getting a color done with your service in order to recieve a haircut/appointment.
YESNO
9
At this time, Leah is not accepting new Haircut Only guests. If you feel this may be a mistake, please email Leah directly at contact@leahnakatahair.com . If you'd like to get a color done, please continue with the application.
10
Check off all of the services you think you might need.
Grey Coverage
Balayage
Highlights
All Over Lightening
All Over Darkening
Haircut
Clipper Cut
Color Correction
Shadow Root
Lowlights
Conditioning Treatment
Product Recommendations
Toner
Styling Lessons
Other
11
Image Field
12
Based upon Leah's Service Menu, what Service Package are you thinking you may need?
Signature Full Head $173+
Signature Half Head $158+
Signature Face Frame $133+
Transformative/Corrective $360+
All Over Color $125+
Other
13
Hair Density Examples
14
How would you describe your hair density/thickness?based on the photo prior
Extra Light
Light
Light - Medium
Medium
Medium Heavy
Heavy
15
Hair Length Chart
16
In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?based on the photo prior
Short
Medium
Long
Extra Long
17
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
18
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
19
What are you looking to get done? Is there anything else you'd like to share?
Huge
Large
Normal
Small
Ok
Ok
20
Please Upload a Current Non Filtered Photo of your hair. Front facing or the back.Do not skip this part. If you have trouble uploading a photo, send them to 916-277-0868
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
21
Please Upload a Inspiration PhotoDo not skip this part. If you have trouble uploading a photo, send them to 916-277-0868
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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