Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

When is the last time you had your hair cut? *

Less than 4 weeks ago

1-2 months ago

2-4 months ago

4-6 months ago

6+ months

When is the last time you had your hair colored? *

I've never had it colored

Less than 4 weeks ago

1-2 months ago

2-4 months ago

4-6 months ago

6+ months

How would you describe your hair texture? *

Select all that apply

Fine

Thick

Course

Smooth

Rough

Straight

Wavy

Curly

Kinky/Coily

How would you describe your hair density? *

Very thin/ actively thinning

Thin

Medium/average

Thick

What days/times are you available? We will make every effort to get you in as soon as possible in line with the information you enter here. The more available you are, the faster we will be able to get you in.

Weekdays 9am-12pm

Weekdays 12pm-4pm

Weeknights 4pm-8pm

Weekends 8-12pm

Weekends 12-4

I will make anything work, I just need to get in ASAP