New Client Submission

1

Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Area Code

Phone Number

3

Email* This field is required.

example@example.com

4

Please select which services you are interested in.* This field is required.

Color

Extensions

Haircut

Treatment

5

Are you working within a budget? If so please provide an estimate.* This field is required.This is to better guide you in a service that fits your wants & needs.

6

Budget Understanding for Extension Services: Do you acknowledge that the minimum cost for an extension installation starts at $350, and the combined cost for purchasing hair and installation will be a minimum of $1,000 or more, prior to any promotional discounts? Every client is different, and there are some exceptions to this dependent on needs/wants. However it should be understood that extensions are a luxury service and priced accordingly.

YESNO

7

If interested in Extension services please list below which method(s) and length(s) you are interested in.This helps me provide you with a more accurate estimate.

8

Can you please describe your hair history from the last 3 years.* This field is required.

9

Do you have any allergic reactions to any type or brand of hair products, or sensitive to any products?* This field is required.Please list any ingredients you are allergic to as best you can.

10

Can you please upload a photo of your current hair. * This field is required.Must be no longer than 1 month old

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

11

Can you please upload a photo of your desired hair goals.* This field is required.Multiple photos are more helpful

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

Do you understand that you must have a card on file to book an appointment?* This field is required.You will not be charged for any services until service is completed unless you "no show" or cancel/change an appointment within a 24 hour notice, which will then lead to a 50% nonrefundable fee of services booked.

YESNO

13

Do I have your permission to take videos/ pictures to use for my social media on various platforms?* This field is required.

YESNO

14

Signature* This field is required.

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