Scintillant Hair Consultation Form

Let’s Get to Know You 🖤* This field is required.

What Are Your Preferred Pronouns?

She/Her

He/Him

They/Them

She/They

He/They

Any

Other

Please Select Your Desired Service(s)* This field is required.*Please note, I am not taking new clients for high maintenance blondes (gray, silver, white, platinum etc) at this moment. Additionally, do not fill out this form for haircut services. Please book a haircut and we will discuss before starting!*

Fashion Color

Balayage

Full Highlights

Partial Highlights

Split Dye

Single All Over Color/ Root Touchup

Corrective Color

Keratin

Other

Inspiration Pics* This field is required.Feel free to add 3-4 images of inspiration that you are interested in getting. *Please note, depending on your hair history your desired result may take multiple sessions. Your hair’s health is always my first priority.*

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

You can upload multiple files here

Current Hair * This field is required.Please leave 3-4 photos of your hair in natural lighting if possible and multiple angles (front, sides, back)

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

You can upload multiple files here

Have You Had Any of These in The Past 2 Years?Skip if not applicable

Permanent hair color

Keratin Treatment

Relaxer

Natural/Henna

Does Your Household Have Hard/Well Water? * This field is required.To the best of your knowledge. Hard/well water can affect the outcome of lightener and color longevity due to large amounts of minerals and color-stripping impurities.

YESNO

Please Give a 2 Year Hair HistoryYou do not have to go into major detail (unless you remember) but give a ballpark of any haircolor (be it professional, box, natural/henna, etc), brand name if you know it and any chemical alterations (relaxer, keratin, perm, etc). Your hair history will often determine what is attainable during our first session.

What is Your Hair’s Current Condition?

Hair loss

Damage due to heat/chemicals

Split ends

Breakage

Itchy scalp

Dry hair

Dandruff

Other

When Was The Last Time You Had Color (Professional or Store Bought) Applied to Your Hair?Please note: If you have colored your hair in the past and applied a color close to your natural over it or have not applied color since the last application, this question will still apply to you. Hair color does not leave your hair on its own, it must be lightened (bleached) or cut out

Have You Had Hair Loss Issues in the Past or any Current Hair Loss Concerns?Skip if not applicable

How Did You Head About Me?If you were referred by a friend, be sure to put their name on the next slide and you will both receive a referral incentive!

Facebook

Instagram

TikTok

Google Search

Referred by a friend

Other

Any Additional Questions, Comments, Concerns?Anything additional you’d like to add? If you have been referred by someone, please be sure to give them credit below!

Terms and Conditions* This field is required.Please note that this is only a consultation form and does not guarantee an appointment or immediate availability. This is simply a way to get to know your hair and give a starting price range quote. Pricing is subject to go up based on factors such as texture, thickness, additional product used and hair length. In the event that adjustments to cut/color are needed, you are advised to respond within a week of the service render date to rectify. After reviewing your form, you will be sent a link to book your appointment via Square Booking. Online booking is how appointments are set, rescheduled and canceled. Business reserves the right to deny service and cancel appointments for any reason. Please note that all sales are final and non refundable. Thank you for your understanding.

Scintillant Hair Consultation Form