Appointment Request Form 2021

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, the closing page will appear.

** PLEASE NOTE if you require an immediate appointment, please call 419-491-0996
Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Are you new to our salon?

Yes, I'm a new guestI come regularlyI've been there before but it's been a while
Preferred days of week
Preferred times

MorningsAfternoonsEvenings
Preferred service provider
Service Requested - Select all that apply

HaircutColorShellac ManicurePedicureManicurePermBrow waxLash Lift/Lash TintFacialDermaplaneCurl Cut DryCurl Cut and CleanseCurl Cleanse and StyleConsultation - May be required prior to a 2+ hour appointment.
Please provide any other pertinent information
Should be Empty:

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Welcome to Hair Chiasso!