2023 New Client Profile & Digital Consultation

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Which New Client Option will you be booking?* This field is required.
Haircut & Basics
Color & Basics
Extensions Consultation
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Before I ever schedule any in person extension consultations, I like to make sure extensions are a perfect fit for you. Please take a few minutes to fill out my extension questionnaire so I can learn more about your hair history and goals.

This will also help answer some of your questions about extensions including the process, maintenance, and pricing.

Within 24 hours of submitting your responses you'll receive an email with a link to book your phone consultation.

Start your questionnaire here! (It should take you less than 5 minutes.)
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Name* This field is required.
First Name
Last Name
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
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
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
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Email* This field is required.
example@example.com
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Birthday* This field is required.
Date
Month
Day
Year
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Cell Phone Number* This field is required.
Please enter a valid phone number.
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How do prefer to be contacted?* This field is required.
Text
Email
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How did you hear about me?* This field is required.
Google search
Facebook
Instagram
Yelp
Referral
Other (please specify)
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What’s the name of the client who referred you to me?* This field is required.
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Please tell me more about how you found my business.* This field is required.
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Have you ever experienced an adverse reaction to hair color?* This field is required.
YESNO
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Please tell me more about your reaction to hair color.* This field is required.
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Please tell me a little about your hair color goals at this appointment.* This field is required.Are you wanting blonding, balayage, highlights, a root touch-up, gray coverage, vivid color…color correction. Tell me anything & everything!
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Upload a few photos of your current hair. It’s ideal if I can see the front and back, unfiltered and in natural light.Trouble uploading? Please text them to me at [515] 650-8582
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Inspiration photosUpload inspiration photos if you have a few saved. If you have trouble uploading your photos feel free to text them to me at (515) 650-8582
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Is there anything else I should know before your appointment? Include anything you think might be important, give me all the details!
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After submitting this form you will be redirected to Whitney's booking site to choose your new client service option & reserve your appointment.

https://whitney-smith.square.site/
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