New Client Intake Form

First Name*

Last Name*

Preferred Name/Nickname

Pronouns

Phone Number (must be able to receive texts)*

Email*

Birthday*

Month

Day

Year

Instagram Handle (if you would like to be tagged in posts)

What would you like to have done?*

Cut

Color

Both

(505) 226 - 7945

1120 Juan Tabo Blvd NE, Albuquerque, NM 87112

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