New Guest Request Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.*Please be sure this is an email that you check often.
example@example.com
3
Phone Number* This field is required.Please provide the best number to reach you at.
Please enter a valid phone number.
4
How many months do you reside in Florida yearly?* This field is required.
I am just visiting
3 months or less
4-8 months
Year round
5
To ensure I can provide the top-notch service my guests deserve, I am currently accepting clients who are full-time residents or who reside here for at least four consecutive months each year. Kindly proceed only if this applies to you. If you have any questions, please don't hesitate to reach out directly at SelphnessHairStudio@gmail.com. Thank you for your time and consideration!
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Mailing Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
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Antigua and Barbuda
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The Bahamas
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Belize
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Bhutan
Bolivia
Bosnia and Herzegovina
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Brazil
Brunei
Bulgaria
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Canada
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The Gambia
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Iran
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Italy
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Japan
Jersey
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Kenya
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Laos
Latvia
Lebanon
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Liberia
Libya
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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
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Samoa
San Marino
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Senegal
Serbia
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Somaliland
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Sudan
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
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Tokelau
Tonga
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Tunisia
Turkey
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Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Are you ONLY looking to book a haircut without a color service?* This field is required.Nicole is currently not accepting new, "Haircut Only," appointments. All color appointment include a haircut, but they are not offered as separate services.
YESNO
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At this time, Nicole is not accepting any new, "Haircut Only," appointments.

If you are wanting to book a color service, please continue on with this application.

All color sessions include a haircut.
9
What services do you think you might need? Check all that apply.* This field is required.*Please scroll down for the complete list of service options.
Haircut
Gray coverage/Root retouch (root area only)
All over solid color (root to ends, single process color)
Partial highlights (foils along the front, sides, & top for brightness)
Full highlights (foils throughout your entire head)
Lowlights
Conditioning Treatment
Color correction
10
What is your goal for your appointment?
Looking to maintain my current style &/or color.
Looking to do something a little different.
Looking for a complete/major change.
11
Here's a quick refresher of Nicole's Service Sessions:*This can be found on her website as well, at: www.SelphnessHairStudio.com
12
Based upon Nicole's Service Menu, what Service Session do you think you may need?* This field is required.*All color sessions include a haircut or treatment.
Selph Renewal ($175+)
Your Signature Selph ($250+)
Redefine Yourselph ($300+)
Selph Shaping ($90)
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What is your availability ?* This field is required.
First available appointment
Wednesday AM
Wednesday PM
Thursday AM
Thursday PM
Friday AM
Friday PM
Saturday AM
Saturday PM
14
Please describe what services you are interested in receiving, along with any additional information about your hair that you think I should know:* This field is required.
15
How did you hear about me?* This field is required.*If through a referral, please share their name so I can thank them!
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Optional but super helpful: If possible, please upload some current photos of your hair so I can get a better sense of our starting point. Photos of the front, sides, and back are especially useful.The best lighting is indirect, natural sunlight—think facing a window or standing outdoors in the shade (no direct sunlight or filters, please). Try to capture your hair from root to tip if you can.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Optional but also very helpful: Do you have any inspiration pictures that you'd like to share? If so, please upload them here!While no single photo can capture everything you like, please share any inspiration photos you may have for your ideal end result. I'd love to see the color, length, and/or style you're looking to achieve.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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CANCELATIONS &/OR RESCHEDULING: Your appointmewnts are very important to me and are held just for you. If circumstances arise that make it necessary for you to adjust or cancel your booked appointment time, I kindly ask that you provide at least a full 24 hours notice. This ensures flexibility in managing my appointments with other guests, and allows for adequate time to fill that space. If proper notice is not given, a fee of 50% of the scheduled service(s) will be applied, with a $30 minimum, and will need to be paid prior to rescheduling.* This field is required.
I accept
19
PUNCTUALITY: If you are running 15 minutes late or more your appointment may need to be rescheduled or may require a portion of your service to be forfeited. It is understood that emergency situations can arise and I will try to accommodate you in any way that I can. Circumstances that call for rescheduling will be treated like a last minute cancellation and may be subject to the cancelation fee.* This field is required.
I accept
20
CONTACTING ME: All text messages and calls are for appointment day arrivals. To contact me regarding any scheduling requests, appointment changes, or questions, please email me at SelphnessHairStudio@gmail.com. Messages will be replied to within 24 business hours.* This field is required.
I accept
21
APPOINTMENT CONFIRMATIONS: You will receive an appointment confirmation 3 days prior to your appointment via email and/or text with instructions to confirm your appointment. Please follow the instructions to do so.*Be advised: these are automated text messages and Selphness Hair Studio does not receive any text messaging.* This field is required.
I accept
Other
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PRICING: All published prices are starting points for services. Prices may vary due to certain factors such as: the hair’s length, density, and condition; the complexity of the service; and the amount of product being used.* This field is required.
I accept
23
SERVICE SATISFACTION: I strive to offer my guests the highest level of guest satisfaction. If you are having challenges with your cut or color, please let me know within 4 days of your visit and I will be happy to correct the issue with no additional charge. The revision policy does not include a full change in the original and agreed upon service, and any revision requests made after the 4 day period from the original service date will be subject to my approval. While this is rare, it is important to communicate my policy.* This field is required.
I accept
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FINISHED RESULTS: Because results are most accurately evaluated on hair that has been dried, smoothed, and properly finished, services are only guaranteed when the hair is blown dry in the salon. If you opt to leave the salon without a styling service, you are relinquishing your rights to the revision policy. * This field is required.
I accept
25
CHILD CARE: To preserve an environment that promotes relaxation please make arrangements to have children cared for during your service. Children are not permitted in the salon unless they are receiving a service and cannot be left unattended.* This field is required.
I accept
I decline & do not wish to proceed with services
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