New Client - Hair Color

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Full Name* This field is required.
First Name
Last Name
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Birth DateMonth and Day Only
Month
Day
Year
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Email* This field is required.
example@example.com
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Phone Number* This field is required.By entering your phone number, you are agreeing to receive text messages from us. Message rates may apply. You can reply STOP to opt-out
Please enter a valid phone number.
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AddressWe want to love on you a little. We send cards, goodies and freebies in the mail.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
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The Bahamas
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Belize
Benin
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Bolivia
Bosnia and Herzegovina
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Brazil
Brunei
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Canada
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The Gambia
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Liberia
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Madagascar
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Maldives
Mali
Malta
Marshall Islands
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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
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Northern Mariana
Norway
Oman
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Palau
Palestine
Panama
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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
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Saint Vincent and the Grenadines
Samoa
San Marino
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Saudi Arabia
Senegal
Serbia
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eSwatini
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Other
Country
6
How did you hear about us?
Website / Online Search
Social Media
Referral
Facebook
Instagram
Nextdoor
Walk In / Drive By
Other
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What are your main hair concerns or challenges? Or are there any previous hair experiences you'd like us to know about?* This field is required.More information is always better. Please include any information that you want us to know.
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Do you love your current hair color
YESNO
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When was your last color service?A guesstimate would be perfect! Skip if you have never colored your hair.
Date
Year
Month
Day
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What type of color have you done over the last 3 years?* This field is required.
Professional - in salon
DIY- Box Dye
Professional & DIY-Box
Never colored my hair
Other
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How would you describe your hair history?Check all that apply.
Extensions
Grey Coverage
Highlights
All Over Darkening
Toner / Gloss
Haircut
Conditioning Treatment
Product Recommendations
Styling Lessons
Color Correction (correcting unwanted tones; total transformation - light-to-dark or dark-to-light
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Which of the Babe Experiences are you interested in getting?
Blonding - partial highlight, gloss/toner, free Fusio treatment, blow out
Brunette - root touch up, color balancing gloss, free Fusio treatment, blow out
Red Hair - root touch up, balancing gloss, free Fusio treatment, blow out
Dimensional - partial highlight, low lights, gloss/toner, free Fusio treatment, blow out
Specialty Blonding - partial highlight, blonding tip outs, gloss/toner, root smudge, free Fusio treatment, blow out
Haircut - luxury hair shampoo, haircut, free Fusio treatment, blow out
Transformational - this is a full corrective color service designed for big changes. Consultations are required to customize your plan and pricing.
Other
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Which Moss Babe would you prefer to work with?* This field is required.
Mondays with Kate Secker
Thursdays with Chloe Kotlarz
Mondays or Thursdays both work in my schedule.
Other
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Let's Make This Right
This is one of the most important steps before you visit the salon. This gives us a better idea of your hair goals before you arrive and helps us get to know you and your hair a little better.

By uploading current and inspiration photos, we can make sure you are scheduled for the right service to get the best results. Your appointment is not confirmed until we receive these photos. See below for some DO's and DON'Ts.
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Upload current photos of your hair.* This field is required.We love to see your gorgeous faces, but we need to see your hair. Back or side view from root to end, please. Does not need to be clean or styled, just down. No ponytails, buns or hats, please.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Upload photos of your inspiration hair.* This field is required.Pinterest is a great resource or if there a photo you have of yourself having a great hair day that you want to repeat. Upload as many as you like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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If you want, send us photos of what you DO NOT like or want to avoid.Pinterest is a great resource or if there a photo you have of yourself having a great hair day that you want to repeat. Upload as many as you like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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How would you describe your hair?Check all that apply.
Fine
Coarse
Smooth
Straight
Wavy
Frizzy
Curly
Damaged
Oily
Dry
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How would you describe your hair density?* This field is required.Only one selection needed here.
Very Thin / Actively Thinning
Thin
Medium / Average
Thick
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Terms & Conditions* This field is required.Before you schedule your appointment online, we ask that you please observe and agree to the following.
By applying to be a model at Moss & Black, you agree to the following: I understand that this is a learning experience and my service will be performed by a licensed New Talent Stylist under the supervision of a master stylist. I understand that timing may take longer than a traditional appointment due to the educational nature of the session. I give Moss & Black Salon permission to take and use photos and/or videos of my hair for educational, marketing, and promotional purposes—including social media, website, and printed materials. I release Moss & Black and its stylists from any liability or claims related to the service or photo use. I understand that model appointments are part of the stylist’s ongoing training, and I’m excited to be part of their journey! I agree to the terms & conditions.
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Thank you for submitting your application. Someone will be in contact with you within the next 48 hours.
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