Experience Customization Form

1
The Salon Address is 2171 E. Thompson Blvd. Ventura

When you park, please stay in your car.

Text the number you recieved the link to this form from,

(805)295-8333 letting me know you're here.

If you need to come into the building immediately to use the restroom, please come in and you maybe have a seat in the front of the salon or in the back patio.

Otherwise, I will let you know when to come inside.

In the meantime, please follow the prompts of this form.
2
What is your Name?* This field is required.
First Name
Last Name
3
Are you more comfortable if the two of us wear a mask today?I will wear one if you'd like me to, whatever you're comfortable with.
Yes, I’d prefer us to wear masks today.
No, I am comfortable without a mask on.
4
What are your Pronouns?
She/Her
She/Them
They/Them
He/Him
He/Them
5
Is this your first time having an appointment with me or are you a returning guest?* This field is required.
This is my 1st time!I'm excited to be back again.
6
Would you like to customize your experience today?* This field is required.CHOOSE A DRINK HERE Your Vibe, Treatments etc.
Yes!No thanks.
7
What Would You Like to Drink?* This field is required.Complimentary
Nothing for Now
Water
Sparkling Water
Hot Coffee
Hot Tea
Drink of the Month: Iced horchata chai
Drink of the Month: Iced horchata chai 21+
Other
8
What kind Sparkling Water would you like?
Lemoncello La Croix
Pamplemouse La Croix
Key Lime La Croix
Surprise Me
9
How are you treating yourself during our time today?Choose on the next slides ->
10
Which Essential Oils would you like for your experience today?* This field is required.Complimentary Luxe Amare made in Ventura
You pick for me!
Nothing today, thank you.
Protection- eucalyptus globulus, eucalyptus radiata, rosemary, peppermint, cedar wood, benzoin, frankincense, clary-sage, black pepper, and natural menthol crystals
True Calm- Bergamot, lavender, benzoin, rose, jasmine, and sandalwood
Immune- eucalyptus, rosemary, vetiver, thyme, clove, cinnamon, and lemon
Tranquility- wild orange, ruby red grapefruit, French lavender, tangerine, and French vanilla
Vitality- lemon, ruby red grapefruit, bergamot, peppermint, lime, and black pepper
11
What would you like to add to your experience?* This field is required.Availability of the service may vary based upon timing, all though availability is likely.
Extra Long Scalp Massage (+$10)
Replenish Masque (Great for all hair types! This hydrating deep conditioning mask helps lock in moisture, fight fizz without weighing down your hair. Paired with an XL scalp massage. +15)
Scalp & Hair Treatment (deepest removal of oxidized minerals, medications, and chemicals from the hair and scalp +$25)
Intensive Repair Treatment(For Dry/Damaged hair +$35)
Malibu Treatment (Mineral Build up Treatment +$15) - Recommended 2-4x a year
Nothing today, thank you.
Other
12
Would you like a complimentary scalp massage today?* This field is required.Included with any service.
YESNO
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What vibe would you prefer for our appointment today?* This field is required.I want your experience to be perfectly tailored and customized to you. This will give me an idea of how I should interact with you throughout our time together today to make it as personalized as possible!
Fun & Energetic
Quieter, Relaxing
I would like to get some work done/I brought a book to read.
Silent Appointment. We’ll have a consultation then I’ll let you do your thing.
No Preference
Other
14
Client Service Agreement (Scroll to Sign)* This field is required.Roxy Bunce Hair Thank you for choosing roxybhair for your hairstyling needs. We are committed to offering a personalized, professional experience while maintaining clear, respectful boundaries to protect both our clients and our business. By signing below, you agree to the following terms and agreements: 😷 Illness Policy If you are feeling unwell or experiencing symptoms of illness, we ask that you please reschedule. This protects you, other clients, and our team. ⏰ Punctuality & Late Arrivals Appointments are carefully scheduled to ensure the best possible experience. If you are more than 15 minutes late, your service may be modified to fit the remaining time, or rescheduled and may require a rebooking fee of 25% of the service. If we do not hear from you within 30 minutes, the appointment will be marked as a No-Show, and 50% will be charged to your card. Repeated late arrivals may result in a rescheduling restriction or additional deposit requirements. ❌ Cancellation Agreement: I understand any appointment with Roxy Bunce not cancelled within 48 hours of the scheduled date and time will prompt the implementation of Roxy's cancellation agreement protocol. You will be charged 50% to your card on file of what the scheduled services were valued at. ♻️ Redo Agreement: I understand if I would like something regarding my service that was spoken about in the consultation tweaked after leaving my scheduled appointment, Roxy will be pleased to accommodate you free of charge in most circumstances. For said complimentary service to be done, this request must be made within 7 days of your initial appointment. Roxy will assess the situation and determine whether the redo is complimentary, product-only, or full service cost. I understand no refunds are allowed under any circumstance. 🔁 Product Return Agreement: I understand a very lightly used product may be exchanged by the next scheduled appointment I have. I will make sure to reach out to Roxy Bunce with my concerns as soon as possible after using the product. 🚭 Salon Etiquette: Our space is designed to be inclusive, calm, and professional. We ask that clients: Speak respectfully Silence mobile devices Refrain from discriminatory or inappropriate conversation Any violation may result in refusal of service.
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