New Client Request Form

1

Full Name

First Name

Last Name

2

Phone NumberPlease enter a valid phone number

Please enter a valid phone number.

3

Email

example@example.com

4

What services are you interested in?(Gray coverage, haircut, lived in hair/balayage, highlights, going dark, fantasy colors, etc)

5

What color is your hair currently?

6

Have you had your hair colored within the past five years?

YESNO

8

If you’ve had your hair colored before what was done?(All over color, toners/gloss, blonding)

9

What is the length of your hair?

Short (above shoulders)

Medium (between collar bones & chest area)

Long

Extra long (mid-back or longer)

11

How often would you like to come in for color or hair maintenance?

Every 4 weeks

Every 6-8 weeks

Every 10-12 weeks

Every 3-6 months

Not sure yet - open to recommendations

12

Are you okay with having pictures/videos taken?📸

Yes, let my inner model shine! ✨

Yes, but I’d prefer my face to not be shown.

No thank you. 💗

13

Insert pictures of your hair currently in good lighting here!This helps me see your natural color, texture, and overall condition before your appointment

14

If you have any inspiration pictures for a haircut or color please insert here!💇🏻‍♀️✨

15

I acknowledge Briana’s cancellation policy. To cancel I require 24 hour notice. If given too short of notice there will be a 25% charge of the service scheduled.

I understand

16

Fun fact about you! 🦋