Welcome

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Name
First Name
Last Name
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Phone Number
Area Code
Phone Number
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Email
example@example.com
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Instagram handle that you want us to collaborate with for social media and stories. Handle
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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How did you hear about me?
Facebook
Instagram
Google
A friend? Who can we thank for sending you in?
Other
TikTok
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Do you have any fashion colors on your hair if so, please let us know what colors and what used to put it on there, a stylist, hair dye other things and if so, list what
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How long has it been since your last color?And what did you have done?
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Describe your natural hair color
Black (level 1-2)
Dark (level 3-4)
Brown (level 5-6)
Light brown (level 7-8)
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Do you currently have any previous highlights in your hair?
YESNO
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How would you describe your hair density?Pick one
Fine
Medium
Thick
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Do you currently have any semi/demi or permanent color on your hair? (Ex. Lowlights, darker root, etc.)
YESNO
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Add a picture of your current hair in natural lighting
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Back of hair
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Inspo pictures, we want to see one
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Inspo picture, add another
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What is your hair budget?We like to have an idea so we can try to find something that works in your budget!
1,500 - 2,000
2,000 - 2,500
3,000 - 3,500
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SignatureFor model pricing on extension reinstall clients must Collaborate on reel/post “and” Share to their story on Facebook, Instagram or TikTok for model pricing to be honored for each appointment. Do you agree to these terms? If so sign below.
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This is a submission to be a hair coloring/extensions model appointment for @ansleyscogginsextenions and 3brinsalon. Models must feel extremely comfortable in front of a camera, wear neutral colors, and have their makeup done. Models should allow a full day minimum during the week for this service. The cost for a model appointment is reduced in exchange for their time/modeling. Whenever I need a model I will pull from this list and reach out to you if you're a good fit so be on the look out!
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SignatureFor any color correction services there is damage that will occur. When removing pigment from the hair, this happens! We are going to lift the safest way possible to ensure the integrity of your hair. That’s why we will have you do a strand test at your consultation, before you come in for other appointments. A consultation and strand test can take up to three hours. 3Brin Salon and Ansley Scoggins Extensions will not be liable for any hair loss or damage.
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SignatureFor color correction services those will also require additional time, usually an additional day. Can you come during the week from 10 to 6? We take our time because we are care about your hair, while working on your hair goals. We also need good lighting for pictures. Sometimes we have to ask you to come back the next day to take them depending on the time of the year and lighting. Can you commit to doing this?
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SignatureAfter reading this are you ready to commit to doing your part and create something Beautiful together?! Click Submit and we’ll be in touch!
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LIABILITY WAIVERI agree to be responsible for my hair and hair extensions. I am aware of how to properly take care of my hair and extensions. I HEREBY RELEASE ANDDISCHARGE ANSLEY SCOGGINS, OWNER OF 3BRINSALON FROM ANY AND ALL CLAIMS FOR PERSONAL INJURY, DEATH, OR DAMAGE ARISING FROM OR IN ANY WAY CONNECTED WITH MY HAIR APPOINTMENT IN PARTICIPATION IN THE ACTIVITY. I agree to terms and conditions of the previously listed waiver. I agree to be photographed and or filmed in the course of the activity. I grant full and unlimited permission to Ansley Scoggins/ 3BrinSalon to use my photographs or any other record of participation in this activity in any social media post, broadcast, telecast or other account of the activity for publicity purposes, without compensation.
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