Consultation Form

Name

Phone

Briefly describe you hair history over the past two years (ie, box color, keratin/chemical straightening, previous highlites, excessive damage, etc).

Briefly explain what you currently LIKE about your hair

Briefly explain what you currently DO NOT LIKE about your hair and/or any current struggles you have with your hair (damage, bad cut, blonde fading brassy, too light or too dark)

What are 1-2 goals you would like to achieve in your first session with your stylist (ie, brightness around the face, rooted/lived in look, brighter ends, gray coverage, dimension, etc)?

Have you ever or are you currently experieceing any type of hair loss?

Yes

Do you currently take any medication with known side effects of hair thinning or hair loss?

Yes

Not Sure

Please list what products (type & brand) you are currently using at home (ie, shampoo, conditioner, heat protectant, etc)

Provide a current picture of your hair

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Provide a current picture of your hair

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Provide an inspiration picture for your hair

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Provide an inspiration picture for your hair

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Thanks for submitting!