New Client Form

1

Full Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Area Code

Phone Number

3

E-mail

example@example.com

4

Preferred Contact Method (Text or Email)* This field is required.

5

Preferred Appointment Days and Times* This field is required.

6

Detailed Hair History from last 5 years, including all chemical and color services.* This field is required.

7

Photo of current hair with no filter and in natural light.* This field is required.

Drag and drop files here

Select files to upload

8

Photo of desired hair inspiration. * This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

9

Can you describe what you like about your inspiration photo?* This field is required.

10

Do you have a budget to achieve your end result? If so, what is your budget?

11

Do you blow dry your hair?* This field is required.

Yes

No

12

Do you air dry your hair?* This field is required.

Yes

No

13

Do you use heat styling tools?* This field is required.

Yes

No

14

Do you have a Brazilian Blowout or Keratin style Smoothing treatment?* This field is required.

Yes

No

15

Do you swim in chlorine often?* This field is required.

Yes

No

16

Do you wear your hair up often?* This field is required.

Yes

No

17

Do you have extensions?* This field is required.

Yes

No

18

If so, what method of extensions?* This field is required.

19

Are you interested in extensions?* This field is required.

Yes

No

20

If so, what method of extensions?