New client request form

Appointment Request
CURRENTLY ON A WAITLIST FOR NEW CLIENTS

PLEASE FILL OUT THE FORM TO BE ADDED TO THE LIST

IT MAY TAKE UP TO A FEW MONTHS TO GET AN APPOINTMENT
Hair color starting at $275
Haircuts $65
Full Name *

First Name Last Name
Phone - Text only *

Area Code Phone Number
E-mail *

Address

New Client to Becky?

Yes No
What day(s) work best for you? Becky is currently in the salon on Thursday and saturday. *

Thursday Saturday
What type of appointment are you requesting?

Color only Haircut only Color + Haircut
Has your hair ever been colored, lightened or chemically treated in any way? *
If Yes, please explain. Please note if there is permanent color on the hair.
PLEASE SUBMIT AT CURRENT PHOTO OF THE FRONT AND BACK OF YOUR HAIR (PREFERABLY IN NATURAL LIGHT). AS WELL AS A GOAL PHOTO OF WHAT YOU ARE HOPING TO ACHIEVE.
FRONT *
BACK *
GOAL PHOTO *
GOAL PHOTO
Additional Comments
Should be Empty:

Appointment Request