Appointment Request Form 2020

Welcome to Hair Chiasso!
Appointment Request Form

We'd like to accommodate your reservation request accurately and promptly.

Filling in all the information requested will expedite this process.

Once your form has been submitted, we will contact you to get your request fulfilled.
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
Preferred days of week
Preferred times

Mornings Afternoons Evenings
Preferred service provider
Service Requested - Select all that apply

Haircut Color Shellac Manicure Pedicure Manicure Perm Brow wax Lash Lift/Lash Tint Facial Dermaplane
Please provide any other pertinent information
COVID COMPLIANT

We care about keeping you safe.

There is a health check at our entrance.

Our stations are 7 feet apart.

We are asking all occupants to wear a mask.

There are partitions between our guest while being shampooed.
Should be Empty:

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Welcome to Hair Chiasso!