New Client Form

Name *

First

Last

Email *

Phone Number *

Who Referred You?

Upload 2 photos of your current hair. Please include a front and back view. *

Click or drag files to this area to upload. You can upload up to 2 files.

Show me your inspiration, upload up to 3 photos!

Click or drag files to this area to upload. You can upload up to 3 files.

What is your goal for this appointment

Hair history from the past three years. This includes all chemical services such as over the counter box dye, perms, relaxers, henna, highlights, as well as sun in or overtone. *

If you have used box dye/overtone/sun in when was the last time it was used on your hair? Please be as accurate as possible?

Do you have well water?

yes
No
Unsure

What at home hair care products are you using?

Please list any allergies

What days of the week and time of day is typically best to book this appointment? *