New Client Application

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
Mailing Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
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Belgium
Belize
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Bermuda
Bhutan
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China
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Colombia
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Cook Islands
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Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
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Ethiopia
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Faroe Islands
Fiji
Finland
France
French Polynesia
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The Gambia
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Ghana
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Iraq
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Laos
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Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
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Malaysia
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Mali
Malta
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Martinique
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Mayotte
Mexico
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Moldova
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Mongolia
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Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
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Nigeria
Niue
Norfolk Island
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Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
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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
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Samoa
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Senegal
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eSwatini
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Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
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Zimbabwe
Other
Country
5
Are you looking to make a Hair or Esthetics appointment?* This field is required.
Hair
Esthetics
6
Are you interested in making an Extensions appointment?* This field is required.
YESNO
7
Have you worn Extensions before?* This field is required.
YESNO
8
What type of Extensions?* This field is required.
Hand Tied/Beaded Weft
I-tip/Kertain
Tape-In
9
What are your hair goals?* This field is required.
Volume
Length & Volume
New Haircolor Transformation
Color Refresh
10
I'm aware Extensions require maintenance that includes blowdrying, daily brushing, using salon quality products.* This field is required.
YESNO
11
Upload photos of inspiration of your dream hair* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
12
Upload 2 photos of your current hair, one overall and one closer to the roots* This field is required.Preferably in natural light. Does not have to be your best selfie, just to get an idea for timing and goals
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
Are you looking to make a Hair appointment?* This field is required.
YESNO
14
What services would you like to have done?* This field is required.
Partial Highlight/Balayage
Grey Coverage
Full Highlight/Balayage
Color Correction
Gloss
Brazilian Blowout
Haircut
Blow Out/Styling
Special Event/ Updo
15
Which best describes your hair type?* This field is required.
Very Curly
Curly
Wavy
Straight
16
Do you have a preferred Stylist you want to make an appointment with?* This field is required.
YESNO
17
Who is your preferred Stylist?* This field is required.
Alex
Idalia
McKenna
Katie M.
Ann
Maria
Molly
Melanie
Jessica
Kaitie F.
Haley L.
Apprentice/Hair Model
18
Tell me about your hair history for the past few years. What services are you currently having done? What are your struggles with your hair?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
19
Tell me a little about your dream hair.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
20
What is your current hair routine? What products are you currently using?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
21
How often are you hoping to schedule maintenance appointments?* This field is required.or is there a specific date by which you'd like your hair to be done?
6 weeks
12 weeks
4 Months
Once a year
Other
22
Upload photos of your Dream Hair Inspiration* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
23
Upload photos of your current hair. One overall and one closer to the roots.* This field is required.It doesn't have to be your best selfie, just to get an idea of timing.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
24
Are you looking to make a Lash Extensions or Tinting Appointment?* This field is required.
YESNO
25
Which of these services would you like?* This field is required.
Lash Tint
Brow Tint
Natural Lash Extensions
Volume Lash Extensions
Hybrid Lash Extensions
26
Are you looking to make a Wax Appointment?* This field is required.
YESNO
27
Which Waxing Services would you like?* This field is required.
Brow
Bikini
Lip
Brazilian
Full Face
Half Leg
Full leg
Arm
Half Arm
28
Are you wanting to book a Facial?* This field is required.
YESNO
29
What type of Facial are you interested in?* This field is required.
Signature Spa Facial
Dermaplaning Facial
Chemical Peel
Anti-Aging Facial
Acne Facial
Back Facial
Teen Facial
30
When is your availability?* This field is required.Please note Saturdays we are open from 9am-3pm
Morning
Afternoon
Late Afternoon / Evening
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Friday
Saturday
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31
What is your Beauty Budget for your first appointment at Alexandra's?* This field is required.
$60-$150
$150-$350
$350-$700
32
How do you hear about Alexandra's?* This field is required.
Instagram
Facebook
Website
Referral
33
Who referred you, so we can thank them!
34
I'm aware Extensions an investment and ready for my dream hair!* This field is required.
Yes, so excited!
Need to know more info
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