New Client Application

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Please enter a valid phone number.

4

City, State

5

How did you hear about RomeosReflections?

7

Service Menu

8

Based upon RomeosReflections Service Menu, what Service Package do you would work best for you?

The Little Things (clipper/buzz cut or shampoo & style)

Trim & Treat (haircut option for anything other than a clipper cut)

Simple & Charming

It's Natural *wink*

Head Turner

Refresh

Retouch

Re-Imagine

9

10

What hair Density do you think have?

11

12

In the State you wear it most often (natural straightened, smoothed curly, etc.) How would you describe your hair length?

13

Hair history within the last 3+ years?

I have colored my own hair.

I haven't had my hair colored in the past 3+ years.

I have gotten my hair done professionally.

Other

14

What is it you want to get done? Is there anything else you'd like to share?