New Client Form

New Client Form

Please complete the entire form so that we can serve you better.
Your Name: *

First Name Last Name
Email Address: *
Email
Phone Number: *

Area Code Phone Number
Please describe any problems or issues you are having with your hair.
Please upload a current picture of your hair in natural light. NO FILTERS PLEASE. *

Upload a File
Max Total Upload Size: 500MB Cancel of
Please upload a desired picture of the hair you want.

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When was the last time at home hair color was applied by you? (NOT PROFESSIONAL HAIR COLOR) *

Within the last year. 1-3 years ago. 3-4 years ago. 5+ years ago Never
How many major hair color changes have you had in the last 2 years? (Example: brown to blond (this would be 1), blond to red (this would be 2).

1 2 3 4+ Not sure
What service are you wanting?

Hair Color Hair Extensions Haircut Blow dry Keratin or Hair Botox Consultation for Hair Color Consultation for Hair Extensions Consultation for Hair Color and Hair Extensions Consultation for Keratin or Hair Botox Other
Please describe the service you are wanting.
Stylist Wanted

Amanda (Consultations are $50) Alexis Makena Doesn’t Matter
What kind of hair extensions are hair you wanting?

Hand Tied Wefts (WE ONLY INSTALL OR MOVE UP WEFTS WE SELL.) Tapes Dreamcatchers or I Tips Klix Don't Know None
Length of hair

Above Shoulders Shoulder Length Below Shoulders
Hair type

Straight Wavy Curly Have Keratin In Now
Is your hair?

Healthy Dry Damaged
I need an appointment by:

Month Day Year
Date
Referred by:
Location Wanted

Delray Beach, FL Zionsville, IN
In order to continue providing the best possible scheduling options to our guests, we require a 24 hour notice should you need to cancel or reschedule your visit. If you cancel your appointment time with less than 24 hour notice, a service fee of 50% of your original service will be charged before you can reschedule.
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