EJB form

Name

First NameLast Name

Phone Number

Area CodePhone Number

Email

example@example.com

When was the last time anything was done to your hair?

Give a short summary of your hair color/chemical history within the last 3 years? (please list any color, box dye, highlights, etc)

Please upload a current photo of your hair:

I have permanent color in my hair :

YESNOUNSURE

Please upload your inspo pictures:

INSPO PIC 1

INSPO PIC 2

Please describe what you love about your inspo pics:

Would prefer my hair done by:

Date

Days of the week that work best for me...

I prefer..

MorningsEveningsOpen AvailabilityDoesn't matter, I'll make it work

How did you hear about me?

InstagramTikTokRefferal

Before/After photo's of my hair

Prefer not tooDon't care - just prefer you can't see my faceYes to any photo's/content

If you see a time that works on my schedule, please go ahead and schedule your appointmentand I will reach out.