Holistic Hair Wellness Digital Consult

Holistic Hair Wellness Digital Consultation Form

Welcome to the Holistic Hair Wellness Family. I can’t wait to meet you! All new guests start working with me here by filling out this digital consultation form. This allows me to get to know you and your hair & scalp concerns and goals so that I can ensure your initial appointment is booked properly. Please complete the form in full before I can consider excepting your request. All requests submitted Saturday and Sunday will be responded to by Tuesday. If you have any questions or need support please email me at Andrea@HolisticHairWellness.com
What is your full name?*

First NameLast Name
Phone Number
Please note, I will respond by text to confirm your appointment
What is your email address?
Please note, I will be reaching out by email to confirm your appointment
What do you love about your hair? *
What do you dislike about your hair?*
How much time do you want to spend on your hair?*
Please upload 2-3 photos of your hair as it looks today. We would like to see it from the back and the front, unfiltered. In natural sunlight is best

Cancelof
What products are you using on your hair now and what are they for?*
How often do you wash your hair?*
Do you feel any discomfort before or after you wash? ex. itchy*
Are you experiencing any hair loss?*
Do you have scalp concerns?*
Please tell me about your concerns.
What is your $ budget for this requested appointment?
When is the last time you had your hair cut?*

Less than 4 weeks ago1-2 months ago2-4 months ago4-6 months ago6 months or more
When is the last time you had your hair colored?

I've never colored my hairLess than 4 weeks ago1-2 months ago2-4 months ago4-6 months ago6 months or moreI don't color my hair
What services do you you generally receive currently? Please check all that apply

HaircutGrey coverage colorBlonde Hair ColorRed Hair ColorBrown Hair ColorAsh Hair ColorFashion Hair ColorFace Framing HighlightsPartial HighlightsFull Head HighlightsBalayageBleaching/extensive blondingOla PlexHair Treatments for dry hairHair Treatments for damage hairScalp TreatmentsDry ScalpDandruffOily ScalpHair lossPsoriasis or EczemaSteam treatmentsChemical smoothing treatmentsChemical relaxerPermHair extensionsShampoo Style
How would you describe your hair strand texture? Select as many as apply.*

FineThickCourseSmoothRoughBone StraightMainly straightWavy (type 2)Curly (type 3)Coily/Kinky (type 4)
How would you describe your hair density?*

Actively thinningVery thinThinMedium/averageThickExtremely Thick
Do you currently have extensions installed in your hair?*

YesNo
What type of extensions have you worn most recently or are you wearing now?

Weft applicationTape-In applicationBeaded applicationFusion applicationSewn-in applicationTemporary/clip-in extensionsUnsure of application method
Please upload 1-2 photos of your HAIR COLOR goals. You can find inspitation photos through google image search, Instagram, Pinterest or anywhere else you've seen hair color you admire.

Cancelof
Please upload 1-2 photos of your HAIRCUT & STYLE goals. You can find inspiration photos through google image search, Instagram, Pinterest or anywhere else you've seen hair you admire. *

Cancelof
What services are you looking to book at our first appointment? Please select all that apply

Extension ConsultationPersonal Shopping TimeConsultationPhone ConsultationHcolor (The organic way-Permanent, 100% grey coverage)Hnectar (The organic way- PPD & Gluten FREE- Grey blending - Semi Permanent hair color for sensitive scalps and damaged hair- Extremely gentle hair color that improves the integrity of your hair while coloring)New Hair Growth Color (root touch up)Face Framing HighlightsPartial HighlightsFull Head HighlightsTonerGlossColor CorrectionOrganic Hair Cleanse & Conditioning10 Min Haircut30 Min Haircut45 Min HaircutBlowoutStyling with IronsSpecial Occasion StyleH-Restore (detangling & instant strengthening treatment)H-Milk (instant moisture & softening hair treatment)Rebuilding Treatment (plant protein and moisture hair treatment)Rebuilding Treatment w/ Infrared Remedy Iron (enhances rebuilding with infrared lights ""flat iron" )Flowerfall Experience (an outer body experience, anti aging treat for your scalp, hair and soul)Detox Scalp ScrubBotanical Head.Spa (Deep Scalp Detox, Scalp Balancing and Hair Treatment)Hair Growing Treatment (for thinning hair/hair loss)Sensitive Scalp TreatmentEczema/Psoriasis TreatmentOily Scalp TreatmentDandruff TreatmentSmoothing TreatmentPermOther
Tell me more about why you are requesting a color correction?
Tell me more about your goals with your color service? What would be your ideal outcome?
What are you goals with hair extensions?

I'd like my hair to be as long as possibleI'd like my hair to be a 2"-3" longer than it is nowI'd like my hair to 4"-6" longer than it is nowI'm looking to blend a haircut I'm growing outMy hair is thin and increasing density is a primary concern
How much water do you drink?
Are you under stress?
Is there anything else we should know before booking your appointment?
What days/times are you available? We will make every effort to get you in as soon as possible in line with the information you enter here. The more available you are, the faster we will be able to get you in.

Weekdays 8am-12pmWeekdays 1pm-4pmWeeknights 4pm-7pmMondaysWednesdaysThursdaysFridaysI will make anything work, I just need to get in ASAPSaturdays I'm willing to pay time and a half for you to come in on your time offSundays I'm willing to pay time and a half for you to come in on your time off
DO you or have you eaten processed foods?

YesNo
Do you eat non-organic fruits and vegetables?

YesNo
Do you eat and or drink dairy? ie cheese, butter, milk, yogurt, ice cream

YesNo
Do you eat meat that is not organic?

YesNo
Do you eat fast food?

YesNo
Do you drink alcohol?

YesNo
By completing this form, I am submitting an appointment request and price quote inquiry.

In response, I will receive an email/text with an appointment confirmation or an alternative time and date option that offers enough time for your hair goals and a general price quote.

Your appointment in salon will begin with a 15 minute full consultation to refine the plan for service.

Generally, new guests that need an alternative time are able to be seen within 2-3 weeks of appointment submission request, but guests with limited availability may have to wait longer to be seen.

Due to increase demand during the holiday season, I require a 7-day notice of any appointment shifts or cancellations. Any appointment cancellation less than 7 days in advance will result in a $100 cancellation fee.

Fee is dues prior to reschedulaling any appointment.

Due to this increase demand I can not gaurantee to fit you back on my schedule prior to January 5, 2023 if any adjustments are made to your appointment after this booking.

By clicking the submit button below, I agree to these terms.
Should be Empty:

Holistic Hair Wellness Digital Consultation Form