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New Guest Request

Please fill out the following form about your hair, hair history, and hair goals. This will help ensure we are a perfect fit!

An in-person consultation may be required if I consider it necessary.

First name*

Last name*

Email*

Phone*

Are you a:

New Guest

Current Guest

Referred by (if applicable):

What service(s) are you looking to have done? (select up to two)*

Classic Coloring

Traditional Blonding

Lived-In Color

Haircut/Styling

Specialty Treatment

How would you describe your hair? (check all that apply)*

short (above chin)

medium (shoulder length)

long (below shoulders)

very long (longer than mid-back)

fine

course

thin

thick

straight

wavy

curly

virgin

healthy

damaged

Have you had any of the following in the last two years? (check all that apply)*

box color (drugstore)

box bleach (drugstore)

fashion color/direct dyes

permanent color (professional)

highlights/balayage (professional)

perm

permanent straightening

keratin treatment/brazilian blowout

What at-home maintenance products are you currently using? (check all that apply)*

drugstore (i.e. Garnier Fructis, Herbal Essences, Pantene, etc.)

professional/salon grade (i.e. Kerastase, Olaplex, Oribe, etc.)

online brand (i.e. Function of Beauty, Prose, Vegamour, etc.)

other

Please upload a current photo of your hair. (front, sides and back)*

Please upload inspiration photo(s).*

Any other comments/concerns:

HOURS

Mon: 9 AM - 5 PM
Wed: 9 AM – 6 PM
Sun: 9 AM – 4PM

ADDRESS

Salon Republic at The Paseo

300 E Colorado Blvd
Studio 104

Pasadena, CA 91101

Located on the 2nd Level, above H&M, across from El Cholo Cafe

CONTACT

hairandmakeupbyjosie@gmail.com

(310) 413-1373

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