Appointment Request Form

Appointment Request Form

Please answer the following questions & we will contact you regarding scheduling.
Select a hair service

Adult Hair CutChild Hair CutSingle Process Color Root Touch UpFantasy Hair ColorSingle Process Color All OverDeep Conditioning TreatmentHair styling (Event / Formal)BlowoutPerm / Body WaveRetexturizing / RelaxerHighlightsBalayageBleach & Tone Touch UpBleach & Tone All OverImage AnalysisOther
Which days are you usually available for appointments?

TuesdayWednesdayThursdayFridaySaturday
What times are you available?

MorningsAfternoonsEveningsAnytimeDepends on the day
Client's Name

First NameLast Name
Client's Phone Number

Area CodePhone Number
Client's Email Address
example@example.com
Tell us everything we need to know about what you hope to achieve with your haircut and/or color.
Which of the following best describes your intention for this appointment?

Transformation / Make overMaintenance / Trim / Color touch upNot Sure / Change makes me nervousNot Sure / I'm open to new ideas
How often do you like to visit the salon?

Every 2 to 4 weeksEvery 10 to 12 weeksEvery 4 to 6 weeksEvery 6 monthsEvery 6 to 8 weeksOnce a yearEvery 8 to 10 weeksOther
How long is your hair?
Please describe the density / thickness of your hair.
How would you describe your hair type / texture?

straightsoft curlwavytight curl / coilsuper tight curl / coilfrizzyOther
Have you used the following in your hair before?

Permanent Hair ColorSemi Permanent Hair ColorHennaKeratin TreatmentBleachRelaxerPerm
When did you last visit a hair salon?

MonthDayYear
Date
When did you last apply professional or unprofessional color in your hair?
How did you hear about us?

FacebookInstagramYouTubeOnline AdvertisementGoogle SearchReferred by a friendNewspaper/MagazineYelpOther
Any special instructions, comments, or requests?
Should be Empty: