Fused Beauty Request Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Appointment I'm looking to book:
*
1-1.5hr session - the little bit extra session $180
2hr session - the most popular session $240
2.5hr session - the comfy session $300
3hr session - the works session $360
I'm feeling ready to book:
*
As soon as possible
Within the next month or 2
Within the next couple of months
The best time of day for me is:
*
Morning
Afternoon
Evening
Anytime
What I’m hoping to achieve at my appointment: (for hair & energy work)
*
Why I'm feeling called to work with Becky:
*
Upload files of your current hair and desired results
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Anything else I'd like to add:
Submit
Should be Empty: