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 Target Practice Hot Stone Massage The "Uni" The 40 Year-Old Virgin 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 Amanda Ayla Chelsey Colleen Crescent Jessica Krissy Regina Melissa (Massage Therapist) 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