New Client Application

1
What is your First Name?* This field is required.
2
What is your Last Name?* This field is required.
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
Please enter a valid phone number.
5
What services would you like to have done?* This field is required.click all that apply
Lived in Highlights
Grey Coverage
Full Transformation(much lighter)
Color Correction
Partial Highlight
Haircut
Fashion Color
Barbering
6
Tell us about your hair history for the past few years. What services are you currently having done? What are your struggles with your hair?* This field is required.
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Large
Normal
Small
Ok
Ok
7
Tell us a little about your dream hair.* This field is required.
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Large
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Small
Ok
Ok
8
What is your current hair routine? What products are you currently using?* This field is required.
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Small
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Ok
9
How often are you hoping to schedule maintenance appointments?* This field is required.
4-6 weeks
8-10 weeks
6-8 weeks
12 weeks+
10
Upload photos of your Dream Hair Inspiration
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
Upload photos of your current hair. One overall and one closer to the roots.It doesn't have to be your best selfie, just to get an idea of timing.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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12
When is your availability?* This field is required.
9am - 12pm
12pm- 3pm
3pm -7pm
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Monday
Tuesday
Wednesday
Thursday
Friday
9am - 12pm
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12pm- 3pm
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3pm -7pm
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9am - 12pm
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12pm- 3pm
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3pm -7pm
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9am - 12pm
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12pm- 3pm
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3pm -7pm
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9am - 12pm
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12pm- 3pm
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3pm -7pm
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9am - 12pm
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12pm- 3pm
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3pm -7pm
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13
Who is your preferred stylist?
Please Select
Please Select
Emma
Hana
Abby
Megan
Amanda
Any Stylist
14
How do you hear about Vermelho?* This field is required.
Instagram
Facebook
Website
Referral
15
Who referred you, so Vermelho can thank them!
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