Appointment Request Form
I am located in Riverside, CA. Please fill in the information below for review. Expect text response within 1-3 business days. I appreciate your patience and look forward to seeing you in my chair.
Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
What days work best for you? Check all that apply (the more flexibility you have the sooner I can accommodate )
Tuesday
Wednesday
Friday
Saturday
What service or services are you looking to book
Haircut
Color
Brazilian Blowout
Styling (Blow Dry)
Hair Extensions
Hair Treatment
What time is ideal for your appointment?
Please share your chemical history. What have you done to your hair chemically within the past 3 years.
Have you used sun-in or henna
Yes
No
Have you ever had a relaxer, perm or keratin treatment
Yes
No
Do you currently have box color on your hair
Yes
No
Please describe what you are currently unhappy about your hair. Please attach 3 Current photos of your natural hair in indirect sunlight. ( please no filters, include front, back & side of full length hair)
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Please describe what your hair goals are and attach 3 inspiration pictures of what you would ideally want it to look like.
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Anything else you would like to say...
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Should be Empty: