New Guest: Hair

Please fill out the form below.

Thank you, we have received your information. See you soon.

* - required field

* First Name

* Last Name

* Mailing Address 1

Address 2

* City

* State

* Zip Code

* Telephone

* Email Address

* Date Of Birth

* Were you referred to us?

If yes, who referred you?

* Who is your desired stylist?

* What is the condition of your scalp?

* How would you describe your hair condition?

* Are you taking any medications that cause thinning?

* Do you have professional color on your hair at this time?

* If you have unprofessional color (at home box dye) in your hair at this time, when was the last time it was colored?

* Select one or more of the following retexturing services, if you've ever had them:

Perm

Straightening (Keratin)

None

* What products are you using at home?

* What do you love most about your hair? If you could change something, what would you change?

* Please select your availability:

Mornings

Evenings

Weekdays

Weekends

Your Photos
Accepted file types: JPEG, GIF
Max File Size 10MB

* Tilt your head down, and snap a picture of your roots:

* Look straight at the camera and smile! If you have shoulder length or longer, please drape some of your hair to the front.

* What is your desired look?

If there is anything else you would like us to know, please type it here:

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