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LLC

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Your Hair Journey Starts Here

Thank you for your interest in Sapphire Lily LLC.

Please complete this form with as much detail as possible. This information helps ensure we are a good fit and allows us to provide the best possible service for your hair needs.

Please note that submitting this form does not guarantee an appointment or specific service.

First name

Last name

Phone

Preferred Method of Contact

Text

Have you colored your hair in the past 3 years?

Yes

If yes, please describe all color services used (box dye, salon color, henna, etc.):

How much grey do you have?

None

Minimal grey

Moderate grey

Fully grey

Have you used any of the following? (Check all that apply)

Box dye

Henna

Metallic salts

Keratin or smoothing treatments

Relaxers or perms

None

Date of your last professional color service:

What services are you looking to schedule:

Haircut

Silk Press

All-over color

Dimensional color

Blonding

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

Fine

Medium

Coarse

Dry

Oily

Damaged

Healthy

Do you experience any scalp concerns? (Check all that apply)

Dryness

Flaking

Sensitivity

Itching

Hair shedding or thinning

None

Do you have any known allergies or sensitivities to hair products, dyes, or fragrances?

Yes

If yes, please explain:

Have you ever experienced irritation, burning, or swelling during or after a hair service?

Yes

How often are you willing to come in for maintenance?

6–8 weeks

8–12 weeks

3–4 times a year

Twice a year

What are your hair goals for this visit and long-term?

I acknowledge that I have read and agree to Sapphire Lily LLC’s Salon Policies.*

Yes

I understand that incomplete or inaccurate hair history may affect results and may require additional services or pricing adjustments.

Yes

How did you hear about Sapphire Lily LLC?

Facebook

Instagram

Google

Referral

Returning client

View our Salon Policies

CONTACT

ADDRESS

4969 Westview Dr. Suite 105, Studio 8, Frederick, Maryland 21703

301 706 4306

sapphirelilyhairsalon@gmail.com

OPENING HOURS

Mon, Wed - Fri:

9am - 5pm

Sat :

9am - 6pm

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