Personal Information

First name

Last name

Email Address

Phone Number

How did you hear about us? (e.g., referral, social media, website, etc.)

Hair History

Have you ever colored your hair before?

If yes, when was your most recent color service?

What type of color services have you had in the past? (Check all that apply)

Current Hair Details

Is your hair currently damaged or fragile?

If yes, please describe:

How would you describe your hair? (Check all that apply)

Do you have hard water at home?

Hair Goals

What are your primary goals for your hair color? (Check all that apply)

Do you have any specific photos or inspiration for your desired style?

How do you typically style your hair on a daily basis?

How much time do you spend on your hair each day?

Do you have any specific photos or inspirations for your desired look?

File upload

How often are you willing to come in for maintenance?

What is your ideal budget for this service?

$150-$200

$200-$250

$250 and up

Other

Allergies and Sensitivities

Do you have any allergies or sensitivities to hair products?

If yes, please specify:

Additional Information

Is there anything else you’d like us to know about your hair or your goals?

Signature

I confirm that the information provided is accurate to the best of my knowledge. I understand that results may vary based on my hair history and condition.

Date