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Colour - Consultation
This form is for in salon consultations. Please use the contact form on the homepage for general enquiries.
First Name
Last Name
Has your hair been tinted or highlighted before?
Yes
No
Email
Are you on any medication that causes hair loss?
Yes
No
Phone
DOB
Do you have a sensitive scalp?
Yes
No
Address
Have you been pregnant in the last 6 months?
Yes
No
Postcode
Have you suffered from Alopecia?
Yes
No
How did you hear about us?
Choose an option
Instagram
Word of mouth
Website
Other
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Are you having Chemotherapy?
Yes
No
Do you give permission for your photos to be used on social media?
Please choose an option
Yes
No
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Any Psoriasis on your scalp?
Yes
No
Instagram name
Suffered hair loss/damage to own hair?
Yes
No
DECLARATION : All deposits are non refundable and in the case that appointment should be cancelled or rescheduled, the deposit will be added to your account as credit as long as any changes or cancellations have been made outside of a 48 hour window leading up to your appointment. If this should happen within that 48 hour window, then the deposit will be lost. Signing this means you adhere to these rules. I certify that all the information provided is correct and I agree to follow the aftercare instructions for my hair extensions and/or colour. I know that if I am to experience any unusual discomfort to my hair to contact my Hair Stylist or Hair Extensionist immediately.
Read and understood.
Received a patch test
Yes
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Your Signature
Clear
Submit
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