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New Client Registration Form

Please note all  information on this form will be kept confidential , no third party sharing. It will be used by  "Healthy Hair Salon Clinic"  for the purpose of hair care, hair restoration and beauty needs only.

We will be sending you our news letter and monthly promotions by email or by postal mail, please leave address in message box. Let us know, which is best for you. Thank You! for completing all the information correctly.