Appointment Request Form

1
Full Name* This field is required.
First Name
Last Name
2
Phone* This field is required.
Area Code
Phone Number
3
E-mail* This field is required.
4
Mailing address * This field is required.
5
Birthday
Date
Month
Day
Year
6
How did you hear about me?* This field is required.
Facebook
Instagram
Google
Friend/family
7
If a friend/family member referred you, who was it? I would love to thank them!
8
How would you describe your hair? (Check all that apply)* This field is required.
Fine (skinny strands)
Medium
Coarse
Thin (not dense)
Medium density
Thick density
Dry
Oily
Damaged
Dull
Heavy
Straight
Curly/wavy
9
How long is your hair?* This field is required.
Short- chin length
Mid-length- chin to shoulders
Long- shoulders to mid back
Extra long- mid back or longer
10
How long ago was your hair last colored?* This field is required.
1-2 months
2-3 months
3-4 months
4-6 months
6+ months
I’ve never colored my hair
11
What do you currently like about your hair color? * This field is required.
12
What do you currently dislike about your hair color?* This field is required.
13
How often are you willing to come back to the salon for maintenance?* This field is required.
Regularly, every 1-2 months
Somewhat often, every 2-3 months
Quarterly, every 3-6months
Occasionally, 1-2 times yearly
14
What types of services are you looking for? (Choose all that apply)* This field is required.
Root retouch- gray coverage/lighter/darker root ($85+)
All over color- one solid color roots to ends ($95)
Highlights ($85-160+)
Balayage/foilayage ($160)
Color correction ($100 hr)
Haircut- can only be booked with color service, not a` la carte ($65)
I have no idea I just know I need a change and I like my inspiration photo!
15
Are you wanting a complete change or maintain what you currently have?* This field is required.
Complete change
Maintain
16
Do you have any top concerns/priorities for your visit? (Budget, time constraints, home maintenance etc.)
Time constraints, budget, goal etc.
17
My schedule is Tuesday 12-6, Wednesday 1-8, Thursday 10-7, Friday 10-4, which of these days/times works best for you? *please note that choosing an evening will most likely take longer to get in vs. a daytime appointment.* This field is required.
18
Please upload 1-2 photos of your current hair as well as 1-2 inspiration photos
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
19
I understand that this is a general consultation intake form and designed so Jill can gather a better idea of what I am looking for and book the correct service. A more in-depth consultation will be done face-to-face at my appointment. I understand that Jill cannot give me an exact quote of my future appointment until I am in her chair. I understand it could take 2-4 weeks to secure an appointment time within Jill’s schedule. The initial investment of my first appointment could be $180-$300 to achieve my goal hair depending on my goal. I also understand my goal hair isn’t guaranteed in one visit.* This field is required.
I accept and agree
20
Colour Lust Hair Studio cancellation policy: I ask that if you have to cancel you do so at minimum 24 hours in advance. A fee of 25% of your scheduled service will be charged if you cancel within 24 hours of your appointment. No showing will result in a fee of 50% of the scheduled services. A $50 deposit will be required to reschedule/book another appointment if cancel within 24 hours of appointment. Thank you for understanding!* This field is required.
I understand and accept
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