Appointment Request Form NAME * First Name Last Name Phone * Email * City or postal (zip) code * New client? * First appointments must pay a one-hour retainer in advance. Please do not send any payment until a date and details have been confirmed. Yes No DESCRIBE YOUR HAIR TYPE AND TEXTURE Hair Length * - Very short (ear) Short (chin) Medium (shoulder) Long (upper back) Very long (mid back) Fade or shave (if no, check not applicable) * - Above the ears Back of the head Above ears & back of head Not applicable Hair density * - Thin (I can see my scalp) Medium (I see my scalp sometimes) Thick (I can't see my scalp) Not sure Curl pattern * kinky (4) coily (3) curly (3) soft wave (2) straight (1) mix curl patterns (2-3) mix curl patterns (3-4) Do you have locs now? * Yes No SERVICES * Check all that apply New locs Maintenance Loc extensions Repair Reattachement Other: Preferred days * Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays When are you NOT available? List specific dates & times Would you like to be notified of a cancelation? * Yes No Would you like to send photos? * By email By Instagram No, unless it is recommended Please provide any further information about your appointment request Thank you for your request! Check your inbox for a response from Karen shortly.If you do not receive an email to your request within 3-5 days (Monday-Friday), please follow up via email: karen@modlocks.com.
