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New Guest Form

Hello Beautiful, Welcome! I am so Thrilled to see you are interested in becoming part of Hair By Melina Family. I can't wait to meet you! This form was created as a tool to help me understand your hair goals and get familiar with your hair.After submitting this form, you will hear back from me within 24 business hours.All of this information will be kept private! So, Let's get you started.
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Birthday *

Month Day Year
Enter 2020 for year
How did you hear about me? *

Google Yelp Facebook Instagram Friend/Family
If a friend/family referred you, who was it? ( I want to personally thank them)
What services are you interested in? *

Gray coverage/ Root touch-up Classic Foils Balayage/Foilyage Platinum Blonde Go Cooler/ashier Go Warmer/richer or more golden Go Darker Hair Treatments (Moisture, Color Enhancement Glaze, Reparative, Clarifying) Taped-in Extensions Haircut (please note at this time I am not providing short Pixie haircuts, If you are interested in that type of cut I will be happy to direct you to another stylist who is an expert in pixie style cuts)
Choose all that applies to your hair *

Fine Thick Dry Frizzy Unrully Oily Dull Heavy Damaged Straight Wavy Curly
Are you currently experiencing any hair or scalp issues? *

Thining hair Hair loss (more than usual) Hair Breakage Scalp irritation/flaking None of the above
How long is your hair? *

Pixie to chin Chin to shoulders Past shoulders Extra Long
Are you looking to do a complete change or do you want to maintain what you have question *

Complete Change Maintain
Your last hair color was done? *

1-2 months ago 3-4 moths ago 5+ months ago I have never colored my hair
How was your previous color applied? *

Done by a professional at a hair salon At home Box color Doesn't apply
Please share your complete hair history within the past 2 years *
How often are you willing to come back to the salon for maintenance? *

Every 4-6 weeks Every 8-12 weeks Every 3-6 months
Which is most important to you? *

Getting to my hair goal as quick as possible Maintaining the integrity of my hair
Date you are looking to get in on or before?

Month Day Year
Date

What days and times works best for you? (please check all that applies)I work 2 Saturdays a month. If you are interested in booking a Saturday appointment please let me know in a comment Box at the end of this form *

Morning (9-12)

Afternoon (12-4)

Evening (4-7)

Sunday

Monday

Tuesday

Upload 2 photos of your hair-front and back, No filters and in natural, shaded lighting, no direct sunlight (optional)

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Upload up to 3 photos of your goal hair (optional)

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Please leave any additional comments or concerns that We didn't address in this form, in the space below.
Please read the following

I understand that this is a general consultation intake form designed so Hair By Melina, can help me choose which service option is best suited for me. I understand that if I desire a more thorough explanation of the coloring process or a detailed analysis of my current hair, I will need to schedule an in person consultation.I understand that submitting this form does not guarantee that my hair goals can be achieved in one session.I understand that submitting this form does not mean that I have an appointment booked
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