New Guest Appointment Request

Name

First NameLast Name

First Name

Last Name

Email

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Birth Month and Day

Phone Number

Format: +1 (000) 000-0000.

Address

Street Address

Street Address Line 2

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How did you find Jessica Bautista?

If a referral, please let me know who to thank!

Check off all of the services you think you may need.

Are you looking to address any specific hair or scalp concerns today, such as dryness, damage, build-up from products/hard water, or lack of shine?

Are you interested in adding energy healing or wellness elements to your appointment?

Based upon Jessica's Service Menu, what Service Package are you thinking you may need?

How would you describe your hair's curl pattern?

How would you describe your hair texture?

How would you describe your hair density/thickness?

In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?

Your hair history within the last 5+ years.

Other

What hair color/product was used on your hair? Please Check all that apply.

Please upload photos of the front and back of your current hair in natural light.

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Please upload at least one inspiration photo.

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Do you have any allergies, medical conditions, injuries, sensitivities, or pain that may impact the outcome of, or your ability to tolerate, your services, or the health of your hair?

Do you have any questions for me or anything else you'd like to share?

I have read, understand, and agree to all policies detailed in this form.

Thanks for sharing what you're hoping for! Based on your answers, Jessica may recommend a quick Color Consultation before your appointment to make sure we land on exactly the right service for your hair. You'll hear from her shortly with next steps.

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