New Client Form
Let us know how we can help you!
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you find us?
What services are you interested in? What is your desired outcome?
What does your at home care look like? (i.e. shampoo, conditioner, styling tools, products, etc.)
Do you have any music preferences? Please note a genre or artist if you prefer a particular type of music.
Please choose the type of environment you prefer
Please Select
Upbeat and Chatty
Quiet with a little bit of talking
Silent appointment
Begin chatty, but end silent
Please list any additional needs I can be mindful of to make your experience more comfortable.
Please list any allergies, sensitivities, or medical conditions related to the skin/scalp that I should know about.
Approximately when was your last haircut?
Submit
Should be Empty: