Intake form

Help us serve you better

Name *

Email address *

What type of service are you interested in?

Please select at least one option.

Children's haircut

Women's haircut

Men's haircut

Hair coloring

What is your preferred appointment date?

What is your preferred appointment time?

Do you have any specific style or preference in mind?

How did you hear about us?

Which service or services are you interested in?

Please select at least one option.

Haarschnitte

Haare färben

Styling

Additional questions or comments

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Coiffure Luceat