New Guest Appointment Request Form

New Guest Intake Form

303 Maple Ave Suite 6 Harleysville, PA 19438
This will take less than 5 Minutes!
Hi there! Welcome to Beyond the Mirror Salon, please complete the information below. Once we receive the form, we will reply with an email to offer appointment day and time options. You will also be able to attach pictures of your current hair as well as a few inspo pictures to help with scheduling the proper service and appointment length.

If you are looking for Bridal Services please email us at teambeyondthemirror@gmail.com. Thank you!
First Name*
Last Name*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell Phone Number*

Area Code Phone Number
Birthday (Month, Day, Year)*
Emergency Contact Information*

First Name Last Name
Emergency Contact Phone #*

Area Code Phone Number
Your Relation to Emergency Contact*
Ex: Partner, Sibling, Parent, Child
How did you hear about us?*

Referral/Friend/RelativeFacebookInstagramGoogle
Who referred you?*

Do you currently have any Allergies, Medical Conditions or Topicals/Medications you are currently using?
Have you ever had an adverse reaction to color?*
Please give details of the reaction. What products were used, what was the reaction, and the date this occurred. *
Please list your color/chemical history from the past 3 years.*
Please list any at home products you currently use.*

Service Re-Do & Retail Return Policy: We strive to offer our guests the highest level of guest satisfaction. If you are having challenges with your cut or color, let us know within 7 days of your visit and we are happy to correct the issue with no additional charge. Should you make a retail purchase that you are unsatisfied with, we will accept retail exchanges at full credit for 15 days from your initial purchase. (Sale items are final sale) No refunds are given for services or products purchased.

Appointment Cancellation Policy: In order to continue providing the best possible scheduling options for our guests, we do require 48 hours’ notice should you need to cancel or reschedule your visit with us. Should you cancel your appointment with less than 48 hours’ notice, a rebooking fee of $25 per service scheduled does apply and will be due before a new appointment is scheduled. In the case of a "no show" the total amount of the missed appointment will be due before your appointment will be rescheduled.

Confidentiality and Privacy: Every client has the right to privacy and confidentiality. The conversations you have with your stylist will remain confidential. Client information and email lists are confidential and will not be sold or shared with outside companies.
*

I have read, understand and agree to Beyond the Mirror Salon's Policies.
Signature*

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New Guest Intake Form