New Client Application

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Area Code

Phone Number

4

City, State

5

How'd you find Hairapy by Amanda?

6

What's the name of your friend who referred you?

8

Available Color Packages

9

Based on the previous menu, what Service Package are you thinking you may need?

Refresh $150+

Time to Brighten Up $270+

Revive $195+

The Unicorn Club $330+

Haircut Only $43+

Shampoo, Cut and Style $65+

Other

10

Hair Density ExamplesThis would be how much hair you have on you whole head, or how "thick" your hair is.

11

How would you describe your hair density/thickness?

12

Hair Length Chart

13

In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?

14

Your hair history within the last 3+ years.

I have colored my own hair.

I have not colored my hair in 3+ years.

I have gotten my hair colored professionally.

Other

16

What are you looking to get done? Is there anything else you'd like to share? The more information you give here the better!