Shaylee L Appointment Request

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email* This field is required.
example@example.com
4
Referred byClient Name
Other: social media, google search, drive by, square
5
Gender
Female
Male
Nonbinary
6
Service Type* This field is required.Please select one
New look
Maintain look
Extension consult
Drastic change
Color refresh
Color gloss
Livid-in color session
Blonding session
Regrowth touch up
Brazilian blowout
Blowout
Women's haircut
Men’s haircut
Kids haircut
Hair replacement consult
Color correction consult
Not sure/ other
7
Date of your previous color?
1-3 months
3-6 months
6 + months ago
Never
8
Within the last 6 months, do you have any of the following?* This field is required.Please check all that apply
Gray hair
Permanent color on your hair
Box dyed hair
Reoccurring scalp conditions
Extensions
Suffered major hair loss
None of these apply
9
Appointment preferred* This field is required.not guaranteed
ASAP
1-2 weeks
1-2 months
Flexible
Timeframe
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Timeframe
ASAP
Row 0, Column 0
1-2 weeks
Row 0, Column 1
1-2 months
Row 0, Column 2
Flexible
Row 0, Column 3
10
Availability* This field is required.Please select your availability
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Open
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Morning
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Afternoon
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Not Avail
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Row 3, Column 5
Open
Morning
Afternoon
Not Avail
Monday
Row 0, Column 0
Tuesday
Row 0, Column 1
Wednesday
Row 0, Column 2
Thursday
Row 0, Column 3
Friday
Row 0, Column 4
Saturday
Row 0, Column 5
Monday
Row 1, Column 0
Tuesday
Row 1, Column 1
Wednesday
Row 1, Column 2
Thursday
Row 1, Column 3
Friday
Row 1, Column 4
Saturday
Row 1, Column 5
Monday
Row 2, Column 0
Tuesday
Row 2, Column 1
Wednesday
Row 2, Column 2
Thursday
Row 2, Column 3
Friday
Row 2, Column 4
Saturday
Row 2, Column 5
Monday
Row 3, Column 0
Tuesday
Row 3, Column 1
Wednesday
Row 3, Column 2
Thursday
Row 3, Column 3
Friday
Row 3, Column 4
Saturday
Row 3, Column 5
1 of 4
11
Pictures of your current hair- FRONT VIEW upload* This field is required.No filter, no selfies & natural lighting with hair down
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
12
Pictures of your current hair- BACK VIEW upload* This field is required.No filter, no selfies & natural lighting with hair down
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
Hair Goals* This field is required.Upload HAIR INSPO pictures of your ultimate dream hair! What inspired you and what goals do you have for your color?
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
Should be Empty: