Service Request Form
Please answer questions to the best of your ability and I will get back to you within 24 hours to follow up and get your request booked. I offer individual on location services, group on location services & in salon services by request if you don’t desire an on location service setting.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Location for Services
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about Untethered Haircare?
*
What is your availability?
*
Weekdays
Weekends
Mornings
Afternoon
Early Evening/Evening
What services are you interested in? Select all that apply:
*
On Location Haircuts
On Location Hair Color
Moms Playgroup Haircut Party
Haircuts & Color
In salon setting request
Other
Please list and describe the services you are looking to get. Please utilize uploading any inspiration photos of your hair desires and what you have going on with your hair right now a few questions down:
How often do you wash your hair? What products do you use? What styling do you do with your hair or want to start doing? Anything else I should know please list here:
We may need to have a virtual consultation to follow up on any requests. Are you open to that call?
Yes
No
Please add a photo of your current hair, in natural/good lighting, Please include your new growth/roots .
Browse Files
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Please add a photo of your current hair, in natural/good lighting.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please add a photo of an inspiration of what you are wanting your hair to be.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please add a photo of an inspiration of what you are wanting your hair to be.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Thank you for filling out this form. I will be in touch within 24 hours of submission. If you have any further details or requests you can email at
Howdy@untetheredhaircareatx.com
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