Form
This form is intended for clients seeking hair color. Especially for new color clients, clients seeking a change with their color, or clients that feel lost with booking and need some help determining which service to book. This form is not a booking confirmation or request, and appointment scheduling through Vagaro is necessary to secure an appointment on my schedule.
I have requested a color appointment and am a new color client/ client seeking a change
I’m not sure what to book, so I’m filling this form out because I need help with booking
Name
First Name
Last Name
Pronouns
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Photos of your hair currently (how you normally wear it) roots to ends in good lighting.
Browse Files
Drag and drop files here
Choose a file
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of
Color inspiration photos (minimum of 3)
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Choose a file
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of
Describe what you like about the color inspiration pictures you sent (placement, tone, amount of lightness, etc.)
Haircut inspiration photos (if applicable)
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Drag and drop files here
Choose a file
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of
Detailed hair history from the last 4 years (color, lightener, perms, temporary dye, Overtone, keratin treatments, etc.)
Have you used henna on your hair in the past 4 years?
Yes
No
Please choose the color maintenance level you are comfortable with (how often you are wanting willing to come into the salon)
Every 4-6 Weeks
Every 6-8 Weeks
Every 8-12 weeks
Once a year
I want to come in once then grow it completely out
Do you have a budget for this initial service, and for ongoing maintenance services? If this is not an issue, you may type “No Budget”
What products/brands do you currently use on your hair? Include shampoo, conditioner, cleansers, scalp treatments, styling products etc.
Have you ever had a reaction or allergy to hair color/lightening?
Do you have any issues with your scalp or hair thinning/hair loss you’d like to discuss at our appointment?
Are you comfortable having your photo or video taken during/before/ after our appointment?
Yes photo or video is OK
Yes Video only
Yes Photo only
No I am not comfortable with either
I understand Liz Hoepp Hairdressing’s cancellation policy and give permission for my card to be charged in the event of a policy violation for the sustainability of their small business.
Yes, I understand
I understand lightener and hair color are chemicals and there is always the risk of adverse affects on hair, skin, and systems of the body.
Yes I understand
Is there anything else you would like me to know for our appointment together?
Submit
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