PERSONAL INFO DOME Kid's Cut Executive Cut Deluxe Cut MVP Service Men's Grey Camouflage Full Color Head Shave Ultimate Shampoo & Head Massage MUG Signature MVP Hot Shave Executive Shave Hot Shave/Haircut Combo Head and Shave Combo Beard Trim PAMPER Full Body Massage Golf or Tennis Massage 15 Minute Chair Massage Hot Stone Massage First Name Last Name Phone Email PREFERRED DATE AND TIME Date / / select Time Select Time 11:00 a.m. 11:30 a.m. 12:00 p.m. 12:30 p.m. 1:00 p.m. 1:30 p.m. 2:00 p.m. 2:30 p.m. 3:00 p.m. 3:30 p.m. 4:00 p.m. 4:30 p.m. 5:00 p.m. 5:30 p.m. 6:00 p.m. 6:30 p.m. 7:00 p.m. 7:30 p.m. 8:00 p.m. Stylist Select Stylist Krissy Jayce Chelsey Crescent Same as last time Try someone new No Preference   Check if first visit ADDITIONAL NOTES

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11515 W. Pico Blvd., Los Angeles, CA 90064  •  (310) 473-0462  •  info@reedersbarbershops.com