Client Request Form

1

What is your first and last name?* This field is required.

First Name

Last Name

2

What is your email address?* This field is required.

example@example.com

3

What is your phone number?* This field is required.

Please enter a valid phone number.

4

How did you hear about us?* This field is required.

5

Which of the following describes your hair?* This field is required.

Fine

Thick

Medium

6

When was your last color service?* This field is required.

Date

7

When would you like to schedule your appointment?* This field is required.

ASAP

Within the month

No Rush

8

Do you have a preferred stylist you would like to see?* This field is required.

9

What type of appointment are you looking for?* This field is required.

Color Only

Color + Extensions

10

Please show us your current hair + your inspiration photos

CURRENT HAIR PHOTOS

- must be photos of your hair currently

- front and back

- natural lighting

11

Current Hair / FRONT* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

Current Hair / BACK* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

13

Inspiration Photos * This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

14

Have you had a chance to review our pricing?* This field is required.https://www.salonshade.com/the-pricing

YESNO

15

Are you currently on any medications that affect your hair?* This field is required.

YESNO

16

Have you had box dye on your hair within the past 5 years?* This field is required.

YESNO

17

Do you have gray hair that you would like to color?* This field is required.

YESNO

18

Do you have any scalp conditions?* This field is required.

YESNO

19

Would you like to schedule a consultation prior to your service to go over any questions or concerns?* This field is required.*required for all new extension installs

YESNO

20

What is your primary goal for your hair, and how can we best help you have a great experience with us?* This field is required.