New Client Consultation Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Cell Phone Number* This field is required.Please Note: Text is my preferred way of communication

Please enter a valid phone number.

4

How did you find me?* This field is required.

5

Who can I thank for your referral?

6

Check all services you think you might need* This field is required.

Cover regrowth/ Grey coverage

Cover regrowth/ Grey coverage & Refresh ends

Highlights and/or lowlights through top/sides ( nothing underneath)

Highlights and/or lowlights through top, sides, and underneath

All-Over darkening

All-Over lightening

Haircut

Haircut Only ( No color service )

Other

7

Based upon Jennifer's Service Menu, what Session block are you thinking you may need?* This field is required.

Haircut Session $52

Color Refresh Session $109+

Signature Color Session $166+

Complete Color Session $218+

Other

8

Please upload a picture of your hair as it looks today. This will ensure we schedule the right service for you.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

9

Are you looking for a change from your current color? Share any inspiration pictures here.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

10

In your own words, what are you looking to have done? Is there anything else you would like to share?