New Client Application Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
City, State* This field is required.
5
How did you find Emily?* This field is required.
6
I am interested in being an Extension Client* This field is required.
YESNO
7
Are you currently wearing extensions?* This field is required.
YESNO
8
Have you worn extensions before?* This field is required.
YESNO
9
What kind of Extensions have you worn before?* This field is required.
Hand-tied/Beaded Row
Keratin Bond/I-tip
Tape-In
10
What kind of extensions do you have in?* This field is required.
Hand-tied/Beaded Row/Weft
Keratin Bond/I-tip
Tape-In
11
How long have you had these extensions in?* This field is required.
12
Did you like your experience with this method? Please explain.* This field is required.
13
How would you explain your hair density?* This field is required.
Thin
Thick
Medium
Very Dense
14
What is the length of your hair?* This field is required.
Above your chin
At your chin
Above your shoulders
Shoulder length
Past your shoulders but above midback
Past your mid back
15
Is your hair colored?* This field is required.
YESNO
16
Did you get your hair colored by a professional?* This field is required.
YESNO
17
I'm aware extensions require regular maintenance and the use of professional products carried in Canvas. I'm prepared to care for my investment!* This field is required.
I Agree
I need more information
18
I am interested in being just a Hair Color Client* This field is required.
YESNO
19
A four year hair color history. Full transparency is essential so that I know what steps need to be taken to achieve your color goals.* This field is required.
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Ok
20
Photos of your hair from the front, back & sides. Take the photos in natural, indirect light with NO flash. Stand in front of a window and take two steps back.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
21
At least 3 inspiration photos* This field is required.on the next slide, add notes of why you like each photo
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
22
Notes on why you like each of the inspiration photos* This field is required.
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Ok
23
When is your availability?Please note: I am in the salon Monday-Thursday, my last appointment is 3:00pm, I do not offer night or weekend appointments.
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Tuesday
Wednesday
Thursday
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24
If you are currently with a colorist, are you happy with your color or are you looking for a change? Please explain.* This field is required.
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Ok
Ok
25
Emily is typically booked out 10+ weeks. For a premium rate of 20% more, would you like to have availability within 4 weeks?* This field is required.
Yes, i'd love to have dream hair ASAP!
Not right now, i'd like to wait for my first appointment
26
Is there anything else you would like to share that would help me help you?* This field is required.
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Ok
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