New Guest Form

New Guest Form

Thank you for taking the time to fill out my New Guest Form. This form is of tremendous value, as I always want to give you the best possible service and experience.
First Name*
Last Name*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*

Area CodePhone Number
Emergency Contact Name

First NameLast Name
Emergency Contact Phone #

Area CodePhone Number
Relation to Emergency Contact
If you are filling out the form for someone else, please provide your name and relationship. Also contact info if different from above.
Sue Smith (Mom of Emily) XXX-XXX-XXXX
How did you find me? *
(Google, Instagram, Friend) If referred by a friend or family please provide their name. I would love to be able to tank them.
What services are you interested in? Click all that apply*

ConsultationCurly CutStandard CutHighlighting/ BlondingGrey Coverage/ ColorConditioning TreatmentClarifying TreatmentStyling LessonOther
What is your current length of hair?
How thick is your hair?

ThinMediumThickExtremely ThickOther
Salon Hours

Tuesday 9-5 Wednesday 8-3 Thursday 9-5 Friday 8-3 Saturday 9-1
Special Circumstance Appointments

If you require an appointment outside our regular hours, I will happily try to accommodate your request whenever possible.

Please note that there may be an additional 20% fee for appointments outside of my standard hours,

I appreciate your understanding and flexibility in working with me to find a convenient time that works for both of us.
Photo of current hairstyle*

Browse Files
Please make sure photo is taken in a well lit area...thanks Cancelof
Inspiration Photo

Browse Files

Cancelof
Tell me about your hair...and anything else you would like me to know.
What do you like or dislike? What would you change?
Over the past 5 years where have you had your hair colored?

I color it myselfAt a salonI've never colored my hairOther
Has your hair ever been chemically damaged ? Have you ever had an adverser reaction?
( Itching, burning, breakage... etc)
Should be Empty: