Appointment Request Form

Full Name

First NameLast Name

Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What date and time work best for you?

Any other specific date and time, if the above selection is not suitable.

Date

Hour MinutesAM/PM Option

When was your last hair appointment and what service(s) did you receive? *

What type of hair concerns or goals do you have? *

What chemical services have you received at a salon in the past?*

Do you have any previous box color or permanent dark color on your hair? *

Do you have any allergies to certain chemicals from past salon experience? *

Would you like to be notified about promotional services?

Do you take any medication? *

Do you suffer hair thinning or hair loss? *

What products do you use at home?*

Do you have concerns with your scalp? (Oiliness, dryness, etc.) *

What products do you use at home?*

Other

What other goals are you looking to achieve with the style of your hair?*

Do you have hair extensions? Would you like to know more about them and what they offer? *

What is your hair routine? How often do you wash it and use heat tools? Do you blow dry your hair or air dry mostly? *

How often are you looking to come to the salon?*

How many hours can you spend at the salon? *

What is your budget for your hair? Including cost of retail if recommended.*

What service are you looking to do? *

Please Upload a picture of your current hair in natural lightening (no bedroom or bathroom lightening) Natural light is outside with not too much sunlight. Then upload at least 3 inspiration photos you like so we can look over them together during your appointment. *

Below is a signature box to certify all your responses and agree to obide by the policies at the salon in terms of deposits for potential color correction or hair extension services.The signature is also to give clairty that you understand that your hair canvas could need to be worked on session by session depending on your hair color history, or if you had previous chemical services that can interfere with your inspiration.This will be discussed before booking an appointment with me to clarify any concerns with your hair and if a large corrective appointment or set of appointments is needed.

Based on my hair history I understand that my potential goal could take a 4-6 hour appointment or even multiple sessions that may involve a corrective color. I certify that all of my answers in this form are accurate and will be able to help my stylist perform the service needed to reach my hair goals. I understand that based on my budget or my time available for my appointment that I may need to reconsider an alternative to my hair goal and to fully trust my stylist to deliver what is best for my time, and my budget, as well as my hair integrity. All concerns and suggestions will be discussed during time of appointment.*

Signature