New Guest Pre-Consultation Form

1
Name* This field is required.Please enter name that you prefer.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
City and State* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
How did you find Melinda?* This field is required.
Facebook
Instagram
LinkedIn
Referred by a friend
5
Check all the services you think you might need.
Grey Coverage
Balayage
Highlights
All Over Lightening
All Over Darkening
Haircut
Shadow Root
Lowlights
Color Correction
Conditioning Treatment
Product Recommendations
Toner
Styling Lessons
Treatment for Hair Loss
Hair Loss Replacement
Other
Other
6
Haircut Only Clients

I am no longer accepting Haircut Only clients. However, I am still accepting clients who want a Haircut and style. This service includes a relaxing shampoo with scalp massage, conditioning treatment, haircut and style.

For Curly Girls

If you are seeking a haircut for curly hair, as a New Guest, the DevaCurl Transformation is required. This service includes a DevaCut to give you the best results for your curl, a shampoo with relaxing scalp massage, clarifying treatment to restore shine, deep conditioner to put moisture back into your curls, education on how to care for your curls, and a beautiful style to enhance the beauty of the curls.
7
How would you describe your previous experiences with getting your hair done?* This field is required.
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Large
Normal
Small
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Ok
8
Hair Density Examples
9
Check the hair density/thickness that best describes your hair.* This field is required.
Extra Light
Light
Light/Medium
Medium
Medium/Heavy
Heavy
Extra Heavy
10
Hair Length Examples
11
Check the hair length that best describes your hair.* This field is required.
Ear Length
Chin Length
Shoulder Length
Armpit Length
Mid-Back Length
12
What is your hair history for the past 3+ years?* This field is required.
I have colored my hair myself.
I have not colored my hair in 3+ years.
I have gotten my hair colored professionally.
Other
13
Please give more details.* This field is required.
14
What did you have in mind to get done to your hair? Anything else you'd like to share?* This field is required.
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Large
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Small
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Ok
15
Please verify that you are human* This field is required.
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