Request An Appointment

Testing

    NAME:

    EMAIL:

    Service Requested:

    5-YEAR CHEMICAL HISTORY:

    Please provide a list of any chemicals used (e.g. relaxers, henna, keratin treatments, hair coloring and volume of developer used, highlights, texturizers, etc.) used on your hair in the last 5 years along with the date.

    TREATMENT:

    DATE:

    TREATMENT:

    DATE:

    TREATMENT:

    DATE:

    TREATMENT:

    DATE:

    ATTACH PHOTOS OF HAIR:

    Please provide a clear photo in front of a white wall

    Natural Hair Wet FRONT

    Natural Hair Wet SIDE

    Natural Hair Wet BACK

    Stretched FRONT

    Stretched BACK

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