Salon Services Model Request Form

Name *

First

Last

Are you at least 18 years of age? *

Phone Number *

Email *

I am available... *

Any specific notes about availability?

What salon services are you interested in? *

My hair type is... *

My hair length is... *

My hair density is... *

When put into a pony tail, how big is the diameter?

Describe your natural hair color... *

Have you ever colored your hair? If yes, when was most recent color done? *

If yes, how often do you color your hair?

If different than natural hair color, describe your current hair color...

Have you ever used box color? *

If yes, how recently?

Have you ever used Henna hair color? *

If yes, how recently?

Have you ever had an allergic reaction to hair color? *

If yes, please describe

How open are you to types of cuts/color? *

Are there types of cut or color techniques/styles you are specifically interested in? Please list below.