New Client Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

How did you hear about Diane K Hair?* This field is required.

Referral from friend or family

Facebook

Instagram

Google Search

5

What friend/family/internet page who referred you?

6

What days of the week are you available?(Check all that work for you)

Thursday

Friday

Saturday

7

What time of the day is best for you?(Check all that work for you)

Mornings 10am- 12pm

Afternoons 12pm- 5pm

Evenings 5pm- 7pm

10

What is your current hair length?

Short

Medium

Long

Extra Long

11

What are your goals for your appointment?

Maintain current style & color

Looking for something a little different

Looking for a complete change

12

When was the last time you colored your hair?

13

In the past year or so, what is your hair's color history?

All color has been done in a salon

Has only been at home color

A mix of at home color and professional

I have not colored my hair in 2+ years

Other

14

If you have current pictures of your hair or inspiration pictures of your goal hair, please upload them hereNot Required

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

15

Is there anything else you'd like to share, tell me a little about why you're looking for a new stylist.