New Client Appt Request

New Client Appointment Request
Select hair services that apply

Custom ColorHair ExtensionsGrey BlendingCorrective ColorHaircutOther
Preferred days of the week

MondayTuesdayWednesdayThursdayFriday
Preferred time of day

MorningMiddayAfternoon
Name

First NameLast Name
Phone Number
Email Address
example@example.com
Please provide photos of the front and back view of your current hair. If possible, please take photos indoor, near a window for natural light. This most accurately represents the color of your hair.
Upload images of your current hair*

You can upload multiple files here
Cancelof
Tell me about your hair. What do you like about it? What do you dislike about it? What aspects are you hoping to address?
Upload images of your dream hair*

You can upload multiple files here
Cancelof
If you are interested in Hair Extensions please describe the goals you would like to achieve. (ex: add length, add density, etc)
Give me all the details! I love them!
Please describe your hairs natural texture
Have you received any of the following hair services or used any of the following products in the last three years?

Permanent hair colorHighlight/balayageGloss/Demi permanent hair colorKeratin treatmentPerm/relaxerBox colorAt home gloss/glazePigmented shampooOther
When was the last time you colored or chemically treated your hair? (professionally or at home)
Give me all the details! I love them!
Are you experiencing any of the following?

Hair sheddingDry/brittle hair that’s breakingRed irritated scalpDry/flakey scalpOily/waxy scalp
How often do you wash your hair?

Every dayEvery other dayTwice a weekOnce a week
How do you typically style your hair? (Select all that apply)

Blow dryAir dryFlat ironCurling ironPony tailsBraidsOther
How did you hear about me?

InstagramGoogle SearchWebsiteSalon Two Zero NineReferred by a friend
Any requests or information that you would like me to be aware of?
Should be Empty:

New Client Appointment Request