Name *

First Name

Last Name

Phone *

(###)

###

####

What services are you interested in?

Haircut

Color

Both

Has your hair been colored in the last 2-3 years?

Yes

No

Have you ever had an allergic reaction to hair color?

No

Yes

How would you describe the overall health of your hair?

My hair is in perfect condition!

My hair is generally healthy.

My hair has seen some sh*t.

Would you prefer a quiet appointment?

Yes, I want to chill out and relax

No, I'd like to chat.

I'm cool either way!