Dominique’s New Client Form

1
Name* This field is required.
First Name
Last Name
Instagram Handle
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 Dominique?* This field is required.
Instagram
Salon's Instagram
Google
Salon Website
TikTok
Referral
5
What services are you interested in?* This field is required.
Highlights
All over one color
Brazilian Blowout
Silk Press
Blowout
Haircut
6
Are you wanting to make an appointment for Rosewood Row extensions?* This field is required.
YESNO
7
Are you wanting to make an appointment for a Traditional Sew in?* This field is required.We offer flip over and partial sew ins, this is a protective style where the majority of your hair is braided down with minimal natural hair loose.
YESNO
8
Have you worn extensions before?* This field is required.
YESNO
9
What methods have you tried?* This field is required.
IBE®️ certified method
I-tip/keratin
Handtied/beaded weft
Tape-Ins
Sew Ins
Other
10
What was your overall experience with this method?* This field is required.
11
What are you hoping to achieve with the addition of hair extensions?* This field is required.
12
Which of the following best describes your hair?* This field is required.
Fine/Thin
Medium/Average
Coarse/Thick
13
Which one of the following best describes the amount of hair you have?* This field is required.
Very Little
Medium
Thick
Super Thick
14
Are you interested in a color appointment?* This field is required.
YESNO
15
Are you looking to change your current color?* This field is required.
Yes, I'm Looking For Something NEW
Yes, But Nothing Major
No, I Like My Current Color
16
Which of the following applies to your current length (without extensions)* This field is required.
Chin Length or Shorter
Chin Length to Shoulder
Shoulder Length to Mid Back
Mermaid - Mid Back or Longer
17
Which of the following best describes your CURRENT hair?* This field is required.
Healthy Overall
Healthy Overall But With Dryness
Slilghtly Compromised Damaged
Over Processed -HELP
18
What is your hair history? What colors/chemicals have done in the past? * This field is required.
Huge
Large
Normal
Small
Ok
Ok
19
What are your hair and scalp concerns at the moment?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
20
How often do you shampoo and style your hair?* This field is required.
21
How often would you like to have your color service done?* This field is required.
4-6 weeks
Every 6 months
12-16 weeks
Once a year
22
Do you have any particular concerns or anything you'd like for me to know? (hair loss, excessive breakage etc)* This field is required.
23
Front View* This field is required.If hair is past shoulders please pull forward to be seen from the front
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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24
Side View* This field is required.preferably upload a photo of each side please
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
25
Back View* This field is required.Please pull all length to the back and include entire length in photo
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
26
Inspiration Photos* This field is required.Upload photos of hair you like
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
27
When is your availability?* This field is required.This is not the booking system but my personal working schedule
9am-12pm
12pm-3pm
3-5pm
Wednesday
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Wednesday
Thursday
Friday
Saturday
9am-12pm
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12pm-3pm
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3-5pm
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9am-12pm
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12pm-3pm
Row 1, Column 1
3-5pm
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9am-12pm
Row 2, Column 0
12pm-3pm
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3-5pm
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9am-12pm
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12pm-3pm
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3-5pm
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Having full knowledge of the financial commitment, timeline, & guidelines to obtain and maintain your hair services of choice, are you prepared to make the investment for your hair experience?* This field is required.(Please check your inbox or spam folder for approval and next steps to book)
YES, Give Me Beautiful Hair
NO, I Can Not Invest At This Time
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