New Client Form

1
Name
First Name
Last Name
2
Preferred Pronouns
3
Phone Number
Please enter a valid phone number.
4
Email
example@example.com
5
I would like to be contacted:
Via Text for Appointment Notifications
Via Text for Promotional Information
Via Email for Appointment Notifications
Via Email for Promotional Information
Via Telepathy if I Win the Lottery
6
How would you describe your hair texture?
Straight
Wavy
Curly
Frizzy
I’m getting mixed messages and it’s stressin’ me out.
7
How would you describe your hair density? (The number of individual hair strands.)
Very Thin
Thin
Average
Thick
Thick AF Shawty
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Very Thin
Thin
Average
Thick
Thick AF Shawty
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
8
How would you describe your scalp health?
Normal
Oily
Dry
Flaky
Itchy
Bitchy
Other
9
How often do you shampoo each week?
5-7 times
3-5 times
2-4 times
0-2 times
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What products are used on your hair? (Ex: Pantene Shampoo, Dove Conditioner, Chipotle Guacamole)
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Do you style your hair with heat?
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What is your main hair concern, if any?
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Is there ANY color on your hair from within the past 5 years?Plz be honest! No judgement!
Yes. Professional color!
Yes. At-home color!
Yes. A combination of professional and at-home color!
No. All natural, baby!
14
Currently the majority of my hair is:(Only fill out if you’re booking a COLOR appointment!)
Brown
Blonde
Gray
Red
Bronde
Something Else
15
A credit or debit card is required to book a service with us.It will be safely and securely added to your profile. We will never charge your card under any circumstance without notifying you first!
Please Select
Please Select
Yes
No
I understand.
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#:    ****- *     ****- *     ****- *     **** *
Expiration:    Month     Year
CVV:    ***
Billing Zip Code:    *****
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I’m looking to:(Only fill out if you’re booking a COLOR appointment!)
Maintain my current hair color.
Slightly alter my current hair color.
Completely change my current hair color.
Get some advice since I’m not sure what hair color I want.
18
Which day of the week typically works best for your schedule?
Sunday
Monday
Tuesday
Wednesday
It Varies
19
#1 MOST IMPORTANT THING TO READ-GETTING TO YOUR APPOINTMENT
The address is 2590 N 12th Ave. My Salon Suite is a white brick building right across the street from East Hill Barber Shop!

If possible, park on the left side of the building closest to Hatton St.

Please contact me after you’ve parked and WAIT for me to instruct you the rest of the way.

The building is locked and I will have to come let you in when I’m ready for you!

POP QUIZ:

I will try to park closest to

I will            you after I park.

After that, I will        for further instruction.

If you don’t follow these instructions you will cause me stress! Please don’t. Lol
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How did you hear about Peach Fuzz?
Type option 2
Type option 3
Type option 4
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I have read and agreed to all policies on the separate policy form. I truly did.Like, seriously. Even the separate form. It’s in my brain!
Yes
No
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How did you hear about Peach Fuzz?
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Image Field
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