New Client Application
Please fill out this form to make sure that Valerie is the right fit for your needs. Upon approval ,you will receive instructions on how to book your first appointment.
Have you had the chance to check Honey and Mane website, and understand all packages and pricing?
*
Yes
No
Back
Next
Name
*
First Name
Last Name
Back
Next
Email
*
example@example.com
Back
Next
Phone Number
*
Please enter a valid phone number.
Back
Next
How did you find Valerie @Honey & Mane?
*
Referral (From friends and/or family)
Instagram
Facebook
Google
Yelp
Other
Back
Next
Who referred you, so we can say Thanks!
Back
Next
Please select all the services you think you might need:
*
Grey Coverage
Balayage
Highlights
All Over Lightening
All Over Darkening
Haircut
Color Correction
Shadow Root
Lowlights
Conditioning Treatment
Product Recommendations
Toner
Curly Girl Haircut
Styling Lessons
Other
Back
Next
How would you describe your hair texture and thickness?
*
Fine
Medium
Coarse
Thin
Thick
Wavy/Curly
Frizzy
Dry
Flat/limp
Damaged
Back
Next
Do any of the following hair/scalp issues affect you currently?
*
Breakage
Dry Scalp
Thinning
Bald Spots
Sensitive Scalp
None of the above
Other, Please Specify
Back
Next
How long is your hair?
*
Short (Above Collar Bone)
Long (Middle of my back)
Medium (Below Collar Bone)
Extra Long (Past the middle of my back)
Back
Next
Your hair story in the last 3 years?
*
I have colored my own hair (box color)
I have not colored my hair in 3+years
I have had my hair colored professionally
I have used Henna
I have had a Relaxer or Smoothing/Straightening Treatment
Other, Please Specify
Back
Next
If you are wanting color, please upload 2-3 of your hair (front & back) in natural shaded light (no direct sunlight)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload 2-3 Inspiration photos.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
In your own words, what are you looking to achieve on your hair journey, anything else you’d like to share?
*
Submit
Should be Empty: