New Client Application

1

Name* This field is required.

First Name

Last Name

2

First Name* This field is required.

3

Last Name* This field is required.

4

Email* This field is required.

example@example.com

5

Phone Number* This field is required.

Please enter a valid phone number.

7

When is your event date?

8

Tell us 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.

9

Tell us a little about your dream hair.* This field is required.

10

What is your current hair routine? What products are you currently using?* This field is required.

11

How often are you hoping to schedule maintenance appointments?* This field is required.

4-6 weeks

8-10 weeks

6-8 weeks

12 weeks+

14

Would you like to book any skincare or browservices?* This field is required.

Facial, Microdermabrasion, Peel

Eyelash Extensions

Eyebrow Wax

Make Up Application

Waxing

Spray Tanning

Next time!

16

Who referred you, so we can thank them!* This field is required.