Color model questionnaire
Name
*
First Name
Last Name
Phone Number
*
Email Address
*
example@example.com
How do you prefer to be contacted?
*
Email
Text
Check any conditions that currently apply to your hair:
*
Lightened
Colored
Permed
Greying
Damaged
None of the above
Some people are sensitive to the chemicals in hair color and lightener. Would you like a skin test performed at least 48 hours ahead of your appointment to determine if you are sensitive to these chemicals?
*
Yes
No
Do you give us permission to use your photo in marketing materials?
*
Yes
No
Please describe your hair and the change you want to achieve or upload a photo of your desired look.
*
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