*NEW CLIENT* Virtual Consult Form 2024

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Please fill out your Name below* This field is required.
First Name
Last Name
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Phone Number* This field is required.
Please enter a valid phone number.
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Email* This field is required.
example@example.com
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Instagram Handle or Name on FB!?I'd love to follow you on social media!
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How did you hear about me?* This field is required.
Instagram
Facebook
A Friend or Acquaintance!
I'm Your Client Already!
Someone Bought Me a Gift Card!
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Who were you referred by or who bought you a gift card?I'd love to thank them!
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What kind of services are you interested in?* This field is required.
Express Custom Color Services + Efficient Extensions
Efficient Extensions Only
Express Custom Color + Haircut
Express Custom Color Only
Haircut Only
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Please upload a current pictures of your hair, front, back, and sides if possible!
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Please upload any inspiration pictures of what you're wanting your hair color, extensions, and/or haircut to look likefeel free to add more than 1 picture
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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In regards to your hair color history, is there anything else I need to know?Share any extra details about what you're looking to get done as well what you have been getting done previously with your hair! Please include if you have used any over the counter color on your hair - walmart, sally's, ulta, overtone etc! *being aware of this is vital in keeping your hair healthy during your appointment*
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If you'd like to add-on a haircut please select yes or no below* This field is required.
Yes please!
No please!
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Do you have any concerns related to your hair that you would like to address?* This field is required.choose none of the above if these concerns don't apply to you
Dullness/Lack of Shine
Breakage
Dryness
Dry Scalp
Product Build Up/Hard Water
None of the above
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SECRET MENU: UNLOCKED!* This field is required.If you would like to add one of these quick services to your appt choose which below! if you are not interested that is totally okay!
Did you book an Express Custom Color service and do you need FULL Grey Coverage, like you don't want to see ANY greys whatsoever? Please select this to let me know. Additional charge can apply!
Luminous Glow Shine Treatment: Includes a deeply nourishing shine treatment, followed by a warm towel wrap and a relaxing scalp massage to promote circulation and enhance shine. $23
Quench & Hydrate Deep Conditioning Treatment: Features a deeply hydrating mask, a relaxing scalp massage to promote absorption, and a warm towel wrap for ultimate pampering. $23
Build-up Buster Treatment: This experience includes a detoxifying pre-wash treatment to give your hair a clean slate, followed by a double clarifying wash, and a hydrating mask, leaving your hair feeling clean, balanced, and revitalized. $33
Scalp Sanctuary Detox Treatment: Includes a gentle scalp scrub to remove impurities, a detoxifying mask to soothe and balance, a customized shampoo, and a deeply hydrating mask. A warm towel wrap and relaxing scalp massage complete this indulgent experience, leaving your scalp feeling refreshed and revitalized. $45
Revive, Repair, Protect with K18: Beginning with a powerful bonding treatment to repair damage at the start of your service. We then follow with a luxurious K18 repair treatment, a warm towel wrap, and a soothing scalp massage for ultimate relaxation and rejuvenation. $45
Brow Perfection Package: Built to give you perfectly defined brows, this comprehensive service includes a brow stain and tint to deepen and fill in your brows, followed by a mindful wax to enhance your natural shape. $33
Brow Stain & Tint Only $17.
Brow Shape & Wax Only $17.
Lip Wax $7.
I'm not interested at this time!
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I currently service clients 3 days a week, tuesdays, wednesdays and fridays, does this work with your availability? Express custom color services start at a range from $133 - $368. They fluctuate in price depending on your unique hair goals! Can you also confirm this is within your budget?* This field is required.
YESNO
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Have you ever wore hair extensions before?* This field is required.
YESNO
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Since you marked "Yes", please provide me with the details of your past experience* This field is required.
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Are you currently wearing hair extensions?* This field is required.I offer a revolutionary brand of extensions that are extremely time efficient and healthy for the scalp, if you chose "YES" to this question, I will reach out to you about the current hair you're wearing and see if it can be converted to this method.
YESNO
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What are you hoping to achieve with hair extensions?* This field is required.
I want length!
Filling in sparseness on the sides!
I want longer and thicker hair!
I'd like to add color with extensions!
I like my length, just want density!
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How would you describe your natural hair density?* This field is required.
Extremely thin
Thick
Thin
Super Thick
Medium Density
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Are there any specific concerns or challenges you have regarding your hair or the extension process?* This field is required.
YESNO
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Since you marked "Yes", can you elaborate if there any specific concerns or challenges you have regarding your hair or the extension process?* This field is required.
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Ok
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What do you currently love about your hair?* This field is required.
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What do you currently dislike about your hair?* This field is required.
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Let me in on your Lifestyle: work, exercise, hobbies?if you like :)
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Ok
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How much time are you willing to dedicate to styling and maintaining your hair + the extensions?* This field is required.
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Ok
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Are you willing to use specific haircare products recommended for your hair extensions?* This field is required.
YESNO
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Hair extensions start at a range from $950 - $2900. They fluctuate in price depending on how many pieces of hair are needed to deliver solution driven result! Can you confirm this is within your budget?* This field is required.
YESNO
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Do you understand that to secure your hair extension appointment I require 50% of the appointment total down. This down payment is nonrefundable and if you cancel this appointment at any time, the down payment will be forfeit. Do you agree?* This field is required.Please type yes if you agree!
YESNO
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If you prefer a "silent appointment" please check YES belowthis just means if you'd prefer conversation to be at a minimum to spend time working, listening to a podcast, reading, or just relaxing!
YESNO
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Do you consent to your hair being photographed or filmed for the purpose of creating content that may be shared on various social media platforms or used in my classes for educational purposes?* This field is required.
YESNO
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IMPORTANT: It is recommended to come in with hair that it is *fairly* clean, best practice would be no more than 3 days dirty, with minimum product used, for best results with color services or hair extensions! Please confirm you've read this below!* This field is required.
YESNO
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Terms and Conditions* This field is required.I understand that this is a general consultation form designed so Delora can determine which services I am best suited for and if she is the right stylist to achieve my hair goals. By submitting this form it does not mean I have an appointment booked nor does it guarantee an appointment.
Yes, I understand!
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Signature* This field is required.
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