Client InformationPlease provide your information for our records Name * First Name Last Name Email * When is your birthday? * Please provide your birth month and day Home Address * Please provide a home mailing address where we may be able to reach you Address 1 Address 2 City State/Province Zip/Postal Code Country Cell Phone * (###) ### #### May We Text You * Are you able to receive text messages at this number for appointment reminders or other details? Yes No Alternate Phone (###) ### #### Preferred Days of the Week for Appointments * Please provide the days of the week that typically work best for you. No Preference Monday Tuesday Wednesday Thursday Friday Saturday Preferred Time of Day for Appointment * Please provide the time of day that typically works best for you (check all that apply). No preference Morning (8AM-9:00AM) Mid Morning (10AM-11AM) Afternoon (12PM-1PM) Mid Afternoon (2PM-3PM) Late Afternoon (4PM-5PM) Evening (After 6PM) Services Needed * Please select the typical services that you need (check all that apply) Cut & Color Retouch Color Only Cut Only - Male Cut Only - Female Cut Only - Child Highlights Style (Blowout, etc.) Treatments (Deep Conditioning, Straightening, Etc) Other (provide details below) Other Services Needed Provide further details on additional services you may need Anything else we should know? * Please provide and additional important details about your style or appointment needs Permission to Use Your Image * We occasionally will use client pictures for marketing or examples of the work we have done. Do we have your permission to use your pictures for promotional use? Yes No Thank you, we appreciate you helping us to keep our records up to date Life is more beautiful when you find the right hair dresser
