New Client Form💌

New Client Consultation Form💌

Hi there, Im Stasia! I specialize in lived-in color transformations and hair loss solutions that prioritize the long-term health and beauty of your hair. Every formula I create is thoughtfully customized to complement your natural undertones, ensuring your color enhances your features and reflects your most radiant, effortless self.My approach blends modern techniques with a deep understanding of hair integrity, so your results not only look beautiful — they last! With my signature color packages, you can enjoy low-maintenance appointments spaced months apart, without sacrificing the luxurious look and feel you deserve.Healthy, effortless hair that suits you perfectly is just a few clicks away. Start by filling out my pre-consultation application, and I’ll personally reach out within 24 hours to guide you through the next steps!
Full Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Please provide your Facebook or instagram handle, and indicate your preferred platform
Preferred appointment experience ?
Describe your hair color history of the last 3 years and the last time you got it done- Please be honest as this ensures predictability in your results and protects your hair
Please upload unedited photos of your current hair- one from the back, and one front facing photo

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Please upload hair goal/ inspiration pictures for your desired hair.Note: Consider the models root color, density, and texture, as these factors affect how achievable the look is for you. Ex: If you're naturally brunette, and the inspiration is a natural blonde, results may vary. Ai generated photos cannot be replicated/keep in mind with pinterest photos.

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Are we focused on going lighter or darker this appointment?
How often do you go to salon? What is your ideal maintenance schedule
When is the last time you visited a salon or did your color application
Date or any approximate weeks
How often do you change the color of your hair?
Every month/Every 2 months/Quarterly/Yearly
Have you applied color at home in the last 3 years? sun in, henna, box dye, store bought toner, hair color depositing masks etc. * Honesty is crucial as this helps me approach our application in the best way to get you closest to your goals!
If yes- please elaborate what color was used, when color was applied and where it was purchased from - ps! color stains the cuticle and remains in the hair strand, which can affect your lift so please be honest! Must state last application*
Are you using any medications or dealing with any health conditions If yes, please list them below: *
Please note* service pricing is individually dependent on hair thickness, density and length. All pricing is starting base price - Additional mixes, product, treatments, and processes utilized are individual to each client. Online estimates may vary.
I acknowledge that appointments are held for 15 minutes before a cancellation fee is sent out, if I am late I understand that my appointment may be limited or rescheduling may be necessary to respect other client's schedule appointment time.
I understand that the business policies instituted are non negotiable. I understand disrespecting policies, my stylist or the salon space will result in a permanent ban from booking
*With my signature I declare I filled out this form with 100% honesty regarding my color history. I understand and accept the notion that depending on my starting canvas, my inspiration pictures may not be realistic or achievable the first appointment. I understand that all realistic options will be provided during an in depth consultation. I am aware all my questions will be answered thoroughly prior to the beginning of the application. If multiple appointments are necessary, I am willing to preserve the integrity of my hair and listen to my stylists professional recommendations. •I understand that with my signature , I give my stylist (Anastasia Prutch) full permission to color and provide a chemical service to my hair.
* I acknowledge that proper maintenance and products will help maintain the longevity of my hair color. I acknowledge that maintaining my color is my responsibility and my stylist (Anastasia Prutch are is held liable for how I maintain my color once I leave the salon.
*I am aware that any chemical or hair coloring services are at risk for certain side effects such as redness, scabbing, bruising, scarring, swelling, tenderness, hyperpigmentation.*****•I have read the above information and if I had any concerns I have addressed them with my stylist. •I give permission to perform the hair color procedure we have discussed and will hold them harmless from any liability that may result from this treatment. •I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or topically using. •I understand my stylist will take every precaution to minimize or eliminate negative reactions. • I am willing to follow the recommendations for a home care regimen that can minimize or eliminate possible negative reactions. •In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult my stylist immediately. •I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. •I certify that I have read and fully understand the above information and that I have had sufficient opportunity for discussion to have any questions answered. •I understand the procedure and accept the risks. •I do not hold my stylist (Anastasia Prutch) responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today.
With this signature , I declare I have signed this color consultation, consent and liability form freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional Waiver and Release of all liability to the full extent of the law.
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New Client Consultation Form💌