EmailMe Form - New Client Intake Form

761 Mountain Ave. (rear building) Springfield, NJ 07081/ 973-921-1600

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Birthday

MM / DD / YYYY

Preferred Contact Method:

What are your hair goals?

May I send you special offers?

May I post pictures of your hair via social media? (face & name will not be posted) *

How did you hear about TruBeauty? *

Cancellation Policy: *

I Agree

We do require a 24-hour notice should you need to cancel or reschedule your visit with us. Should you cancel your appointment with less than 24 hours notice, a fee of $25 per service canceled does apply and will be due before a new appointment is scheduled. Future appointments will not be booked until service charges are paid.

Text
Call
Email

YES
NO

YES
NO

Referral
Google Search
Social Media
Other