Hairstylist Intake

First Name*

Last Name*

Phone Number*

Phone

Email*

What is your preferred communication method?*

Select

Please provide additional information on your anticipated availability

In general, how much advanced notice do you require to schedule an appointment?*

48 Hours or Less

1 Week

2 Weeks

More Than 2 Weeks

Do you have experience cutting and styling textured hair?*

Will you be brining your own personal equipment?*

Yes

No

Are there any supplies you need us to provide?

We have basic equipment and supplies available (shampoo/conditioner, towels, razors, cleaning supplies)

Is there anything you would like to know about the patient prior to the appointment?

We plan to provide age range, preferred language, requested services, hair type, known allergies

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