Afterpay appointment request form

Paying with afterpay is at the discretion of the stylists. If you are not a current client, fill out this form to book an appointment.

In order to use after pay you are required to set up your account, verify billing and information prior to your scheduled service.
You cannot use after pay at the time of online check out. Payment can only be accepted in person using the Pay in store feature.

appointment request

Our top priority at Death Moth Studio is our clients.

We want to ensure you are receiving a service curated specifically for you.

Fill out the form below to help us better serve you!

Name

First Name

Last Name

Phone

(###)

###

####

Message

Please describe the types of services + treatments you have received for the past 2 years. Include the type of service you are interested in receiving (ex. balayage, toner or cut)

Who is your preferred stylist?

Connie Viera

Fern Martinez

Amber Longoria

Are you comfortable having your name and likeness used on social media?

Yes

Are you comfortable with our assistant aiding with your service?

Yes

Please submit 3 photos of your current hair in natural light (front, side, back) and 1-3 inspiration pictures. No bathroom photos.

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How did you hear about us?

Liability Release Waiver

Welcome to Death Moth Studio We are committed to providing you with unparalleled services and products. Please complete the following form as thoroughly as possible to help us achieve this goal. Thank you for choosing Death Moth Studio. It is our pleasure to serve you. Release Form for Hair Services Involving Bleach I, the above named client request a service performed by the above noted licensed stylist at the above noted address. It is important for the client to understand that the darker the hair color initially is, the harder it will be to lift to a blonde and that it may not be a one time process to achieve desired results. Based on the stylists skills she will try her best to lift as light as the hair will take, tone, and cover with lighter color if needed. The above noted stylist can not be held responsible for any adverse effects or for less than desired results. But the client may request for a strand or patch test beforehand. The client must understand the price + tax is a one time fee and understands that there are no refunds but a makeup service may be preformed under the stylists discretion. Client must also understand hair may feel dry, brittle, or mushy with the chance of breakage and that there will be more maintenance involving the care of her hair afterwards such as deep conditioning treatments and more use of professional products. This release exempts any satisfaction guarantees offered as blonde has very different results on different types/colors of hair. Client understands that bleach strips the hair of its protein and the option of going back to a darker color is not possible within the first couple of weeks of bleaching. Client understands that toner longevity depends on products used at home, the temperature of the water used while washing hair and the frequency of hair washing. Toner typically lasts 4-6 weeks but may change based on hair porosity and general health of hair The client, by signing below, agree to have read, understand, and accept the terms of this contract.

Afterpay appointment request form

appointment request

For Faq’s and booking policies click here.

Hours:

Death Moth Studio