Color Consultation Form
CocoaLovesHair
Name
*
First Name
Last Name
Email
*
example@example.com
Please provide your phone number below
*
Please enter a valid phone number.
Format: (000) 000-0000.
What type of service are you looking for to have done?
*
Please provide a clear photo of your current hair. **Must be less than 1 month old. Front
*
Browse Files
Drag and drop files here
Choose a file
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of
Side
*
Browse Files
Drag and drop files here
Choose a file
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of
Back
*
Browse Files
Drag and drop files here
Choose a file
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of
Please provide only 1-2 Inspiration Photo for what you are looking to achieve. Please be realistic and make sure the picture is close to your hair texture.
*
Browse Files
Drag and drop files here
Choose a file
Ex: If you have hair curly like Shakira. Don't upload a picture of Jennifer Lopez
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of
Please provide a Brief Hair Color / Chemical History of the past 5 years (cellophane, rinse, box color, perm etc.)
*
Do not put N/A. If you haven't did anything to your hair in 5 year write "Nothing."
Please list any allergies
*
Are you taking any medications. If so, please indicate below:
*
Have you completed the 30-day detox?
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Yes
No
Not sure what that is
What shampoo, conditioner and styler do you use (Please mention any butter or oils)? How often do you shampoo your hair?
*
Are you prepared to purchase recommended product that may be necessary for the preparation process?
*
Yes
No
Do you understand that to secure an appointment a $50 nonrefundable retainer is required. It will be applied toward your service. If you are to reschedule with less than 48hour notice, the deposit will be lost, and you will need a new deposit. Cancellation in less than 48 hours or No Show results in a 50% service charge that your deposit will be applied to.
*
Yes
Partial Custom Color starts at $300 & Custom Color Services Start at $400 and up. Please confirm that this is within your budget to invest in your beautiful curls.
*
Yes
When was your last cut?
Would you like to add a Haircut?
Yes, a haircut
Color only please
Do I have your permission to take pictures or videos of your hair for content creation purposes that may be shared on social media platforms?
*
Yes
No
Signature
*
Continue
Continue
Should be Empty: