VIRTUAL CONSULTATION FORM

VIRTUAL CONSULTATION FORM

IF YOU HAVE ALREADY SCHEDULED AN APPOINTMENT WITH US, PLEASE FILL OUT THE FORM BELOW. THIS FORM MUST BE COMPLETED WITHIN 48 HOURS OF BOOKING TO HOLD YOUR APPOINTMENT.
If you have an existing appointment, what is the date and time of your appointment?
Ex: 01/01/21 at 10:00am
Let's get to know you!
Name*

First NameLast Name
Date of Birth*
*If you are under the age of 18 you must be accompanied by an adult and they must sign the waiver below*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How do you prefer us to confirm your appointment? (Choose all that apply)*

PhoneEmailText
How were you referred to us?*
All about your hair!
How long is your hair?*

Pixie (above the ears)Short (in between ears and chin)Medium (below chin to shoulders)Long (below shoulders to mid-back)Extra Long (mid-back and longer)
How would you describe the condition of your hair?*

HealthySlightly damagedVery damaged
Have you had your hair professionally colored in the past 2 years? If so, please describe the services you have had.*
Have you used any at-home color, box color or had your hair colored by someone who is not a licensed cosmetologist in the past 2 years? If so, please describe what products were used and what was done to your hair.*
Do you have any known scalp or skin allergies, irritations, we should know about?*
Have you had any of the following services in the past two years?*

Permanent WaveRelaxerKeratin TreatmentsNone
How often do you wash your hair weekly?*

1-23-45-7Other
What hair care products are you currently using?*
If using drugstore brands like Pantene, Herbal Essences, etc. We may have to do a clarifying shampoo treatment before your service to remove any wax/chemical build up.
What is your styling routine?*
Please upload a FRONT and BACK image of your hair in natural lighting. (Near a window or outside is best.)*

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What service would you like to book?
Let's make your hair dreams come true!
Because maintenance is an important factor in making your dream hair last, how often do you want to visit us to maintain your look?*

None, I just one color session.6 months or more3-6 months6-12 weeksAs often as I need to.
Let us see your inspiration pictures - upload up to 3 pictures.*

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Tell us what you love about these inspiration pictures.*
General Waiver and Release of Liability
It is my choice to receive services. I understand that any information given is strictly confidential and will be used for no other purpose than to assist the technician in providing a suitable treatment which would take into consideration to my specific requirements. I also understand that failure on my part to disclose information could result in injury and/or illness and I hereby release American Salon and Spa, the technician, Aveda Corporation, and its parent company from any claims resulting from such. I release any responsibility and/or liability concerning the application, processing and consquences of the chemical procedure of my hair. Any information provided to me by the technician is for general educational purposes only and is not intended for any medical purpose.
Signature*

Clear
Date of Signature*

MonthDayYear
Date
Cancellation and Appointment Policies
We respectfully request at least 48-hour notice for cancellations.

Please understand that when you forget to cancel or reschedule your appointment without enough notice, we miss the opportunity to fill that appointment time with guests on our waiting list. When an appointment is properly cancelled or rescheduled it allows us time to inform our guests that are waiting for appointment availability, as well as keeping our team members schedules full, thus better serving everyone.

Appointments are confirmed through text, email or phone call depending on your preference. However, if we are unable to reach you, please understand that it is your responsibility to remember your appointment dates and times.

The below charges will be charged to the Credit Card you give us below.
- Appointments that are not cancelled within 48 hours will be charged 100% of the reserved service amount.
- Appointments that are made on the same day and need to be canceled, or are a “NO SHOW” will be charged 100% of the reserved service amount.
**We will waive charges when the appointment is cancelled due to Covid-19 exposure or other contagious illnesses.**

If you need to cancel your appointment after business hours please leave us a voicemail, or you can email us at appointments@americansalonspa.com.
Signature*

Clear
Date of Signature*

MonthDayYear
Date
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VIRTUAL CONSULTATION FORM

Let's get to know you!

All about your hair!

Let's make your hair dreams come true!

General Waiver and Release of Liability

Cancellation and Appointment Policies