Please provide us with some information about the your current hair condition, history and desired look. Please complete this form and we will contact you to schedule your appointment.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Preferred date

MM

DD

YYYY

Preferred Time of Day

Hour

Minute

Second

Please provide us with a brief history of your Hair.

(Previous colour, highlights, box colour, keratin treatments, any damage, etc.)

Preferred Stylist

COLOUR/Extention intake form

LOKI HAIR STUDIO