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New Client Submission Form
First Name
Last Name
Phone
Email
Previous hair/color experience
What is your health history with your hair?
Which best describes your home maintenance regimen?
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Wash and Condition Weekly
Daily Moisturizing and Styling
Protective Styles with Minimal Maintenance
Occasional Care as Needed
Minimal to No Hair Care Routine
Which services are you looking for?
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Current Hair Goals?
Are you currently on any medications? Or any health history regarding hair or skin issues?
Any additional notes or information
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