Appointment Request Form

1

Full Name* This field is required.

First Name

Last Name

2

Contact Number* This field is required.

Please enter a valid phone number.

3

Email Address* This field is required.

example@example.com

4

which service are you requesting?* This field is required.

Luxury Extensions (consult)

Blow dry -1h

Gloss/Toner -1h

Root touch up + haircut -2h

Partial highlight +haircut -2.5h

Colour, highlight, haircut -3h

Beachy bronde -3.5h

Dimensional brunette -4h

5

Please provide a brief hair history * This field is required.Any chemical or colour service you have had in the past 5 years. (Henna included)

6

Preferred Appointment days.* This field is required.

Tuesday

Thursday

Friday

Saturday

7

Preferred Appointment Times* This field is required.

Morning (9am-12pm)

Early afternoon (12pm-3pm)

Evening (3pm-7pm)