New Client Form
Full Name
*
First Name
Last Name
Cell Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
How did you hear about me?
*
Please Select
Referral
Facebook
Instagram
Google
Other
If you were referred, who was it by?
*
What are you looking to have done? Be very specific and detailed as possible!
Have you ever used box color?
Yes
No
Have you ever had your hair lightened with bleach?
Yes
No
Do you have well water?
Yes
No
When was the last time you had your hair done whether it was at home or done professionally?
*
What brand are you using for shampoo and conditioner?
*
What type of heat are you applying to your hair? Blow dryer, curling iron, flat iron?
*
What is your availability for an appointment? Please list days and time frames
*
Example: Wednesday 10am-4:00pm Thursday 3:30pm and on
What form of payment will you be using?
*
Cash
Zelle
Venmo
Credit Card (5% service fee)
I understand that an in person consultation is required before booking. After consultation a non refundable deposit is required to book the hair appointment and will go towards the final total. I understand the deposit will not be refunded to me if appt is canceled or no showed
*
Yes, I understand
Signature
*
Today’s Date:
*
-
Month
-
Day
Year
Date
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