New Guest Application

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
What's your availability normally look like?This will help me know when you are available for a consultation and future appointments. The more options the easier it is for me to see if we will be a good fit.
Times (Ex: 12:00AM-12:00PM)
Tueday
Row 0, Column 0
Wednesday
Row 1, Column 0
Thursday
Row 2, Column 0
Friday
Row 3, Column 0
Saturday
Row 4, Column 0
Tueday
Wednesday
Thursday
Friday
Saturday
Times (Ex: 12:00AM-12:00PM)
Row 0, Column 0
Times (Ex: 12:00AM-12:00PM)
Row 1, Column 0
Times (Ex: 12:00AM-12:00PM)
Row 2, Column 0
Times (Ex: 12:00AM-12:00PM)
Row 3, Column 0
Times (Ex: 12:00AM-12:00PM)
Row 4, Column 0
1 of 5
6
Are you looking to get extensions?* This field is required.
YESNO
7
At this time Heidi is only accepting new extension clients, whether that's with or without other services. For any inquiries regarding non-extension related services, Heidi recommends the following salons:

Their instagrams are

@deluxutah

@amberrenesalon

@cami_beauty

We apologize for the inconvenience and wish you the best of luck in your search for the right stylist for you.
8
What financial investment are you prepared to make?Extension Services with Heidi on average can cost anywhere between $800 - $2000. The final price of your service will vary greatly based upon the desired result and amount of hair & rows needed.
$900-1200
$1200-1500
$1500-2400
$2400+
Other
9
Are you looking for color services also?* This field is required.
YESNO
10
What color services do you think you'll need?
Balayage
Root Retouch
Gray Coverage
Highlights
All Over Lightening
All Over Darkening
Toner
Shadow Root
Lowlights
Roots to Ends Color
Color Correction
Other
11
What's your hair history look like?In the past 5 years
I have only gotten my hair professionally colored.
I have colored my hair myself.
I have used color from a drugstore, grocery store, etc.
12
Please do your best to describe what color service you're looking to get.
13
Have you ever had any allergic/adverse reactions to color on your scalp or skin.* This field is required.
YESNO
14
Have you ever had extensions?* This field is required.
Yes
No
Yes, I have them installed right now
Other
15
If you have had extensions or currently have them installed, please describe the method, type and anything else about them to the best of your ability.* This field is required.
16
What is the length of your natural hair? Please select all that apply.* This field is required.
Chin Length
Chin Length on the sides, shoulder length in the back
Resting on shoulders
Below collar bone
Nearing elbow
Shorter than chin length
17
Which best describes your hair strands?* This field is required.
Fine
Medium
Course
18
Which best describes your density?* This field is required.
Thin
Medium
Thick
19
Have you recently experienced a significant amount of hair loss?* This field is required.(In the last 3 months)
YESNO
20
What are you hoping to achieve with extensions?* This field is required.
Add fullness and keep my length
Add some length and fullness (1-2 inches longer)
Add lots of length and fullness (3+ inches longer)
Other
21
How long do you plan on wearing extensions?* This field is required.
Long enough to get through a phase with my Hair
For an upcoming event
To infinity and Beyond
22
Picture of your current hairSnap a Selfie. Take a good pic of your hair near a window with the light coming in behind the camera. Not direct sunlight but well lit
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
23
Inspiration Picture
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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24
Is there anything else you think Heidi should know?
Should be Empty: