Khloe's New Client Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

How did you hear about me?* This field is required.

Referral from friend or family

Google Search

Facebook

Instagram

5

What is the name of the friend/family who referred you?

6

What is your availability for appointments? (Check all that apply)* This field is required.

Weekday Mornings

Weekday Afternoons

Evenings

Weekends

7

Unfortunately, I am not currently taking new evening or weekend appointments

at this time.

If you have other availability, feel free to use the back button to change your response and proceed with finishing this form.

8

What services are you looking to schedule? (Check all that apply)

Women's Haircut

Hair Color

Hair Extensions

10

What are your goals for this appointment?* This field is required.

Maintain current color & style

Looking for something a little different

Looking for a complete change

11

In the past year or so, what has been your hair's color history?* This field is required.

All color has been done in a salon

Has only been at-home color

A mix of at-home and professional salon color

I have not colored my hair in 2+ years

Other, please specify

12

When was the last time you colored your hair?* This field is required.

13

What hair color/products did you use? (Check all that apply)* This field is required.

Sally's Beauty Supply (Or other public beauty supply)

Drugstore/Grocery Store

Online

Box Dye

Temporary Hair Color Rinse

Other

14

If you have any inspiration pictures of your dream hair, please upload them here!Not required, but it helps!

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

15

Is there anything else you'd like to share?* This field is required.This is a great place to explain where your hair is now, your hair goals, and anything else that feels relevant!