Client Intake Form

1

Full Name* This field is required.

First Name

Last Name

2

Email Address* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Preferred Method of Contact* This field is required.

Text

Email

Phone Call

6

Hair Density* This field is required.

High

Meduim

Low

Unsure

7

Hair length* This field is required.

Short

Medium

Long

8

Have you had any of these services in the last 12 months* This field is required.

Relaxer

Texturizer

Color/Highlights

Keratin/Smoothing Treatment

None

9

What is your hair goal ( Example: Definition, moisture, frizz control, Consistency, learning styling at home.* This field is required.

10

Allergies or Sensitivities (please specify any known issues* This field is required.

12

Anything else would you like for us to know?

13

Impor* This field is required.

I understand color service pricing may vary based on hair density and length. I understand that detangling, excessive matting may require additional time and fees. I understand that by submitting this form I'm requesting an appointment in response I will receive service recommendations, specific price, and booking link ( if approved.) If not, with my permission I will be recommended a stylist that might be the right fit for me.

Other

14

Cancelation Policy: A minimum of 48 hours' notice is required for a full refund. No refund will be issued for late cancellations
Policy Acknowledgement

15

Upload a current picture of your hair and ideal pictures if any (optional)

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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