S Hair Intake form

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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Service of interestDescribe color (lightening, gray coverage, fantasy) Haircut, Treatment, Education, Hair Extensions
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Working hours are Sunday 11am-6pm, Monday 11am-6pm, Tuesday 1pm-8pm. What is your ideal day(s) and time frame for scheduling?Keratin treatments are only available on Tuesdays at 5pm. After hours and day off appointments available upon request.
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Provide a brief Hair Color/ Chemical history for the past 5 yearsIncluding any Keratin / chemical treatments, henna or color depositing shampoos and coditioners.
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Large
Normal
Small
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Ok
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Current Hair Length
Short (above ear)
Medium (shoulders/collar bone)
Long ( Past shoulder blades)
Extra Long (passed lower back)
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Hair TextureApply as many needed
Straight 1a 1b 1c
Wavy 2a 2b 2c
Curly / Coils 3a 3b 3c
Tight Coils 4a 4b 4c
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Hair DensityAbundance
Low
Medium
High
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Hair Color FamilyWhat hair color family is your current hair in?
Black /Dark Brown
Medium / Light Brown
Red / Auburn / Strawberry / Copper
Blonde / Lightened / Fantasy Hair Color
Gray / Salt + Pepper / White Silver
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Please list any allergies and/or sensitivities you may have Scent, sensory, essential oils, ingredients, chemicals (please note that the hair salon is not a scent free space)
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Large
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Small
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Ok
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Some medications and element exposure can affect the color process. For the safety of all - prior to starting any chemical service I agree to a chelating treatment which reduces the risk of hazardous chemical reactions / burns.Chelating treatments must be done as needed or instructed by operators no exceptions. Declining chelating treatments will result in not receiving any color/chemical service. (This is not required for haircut only services.)
YESNO
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I agree to temporarily stop using minoxidil (rogaine) and/or any color pigmented products 1 week before any Color/Chemical servicesProducts such as these can affect coloring / lightening process which can end in undesirable results and or hazardous chemical reactions. (This is not required for haircut only services)
YESNO
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Do you prefer a silent appointment No small talk, just relax
YESNO
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Photo / Video Consent Do you consent to your service being photographed / Video for social media, education or marketing purpose?
YESNO
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PLEASE READ CAREFULLY:

Pricing Packages are full service.

New Client Hair Color with Haircut - $495+

New Client Hair color without Haircut - $395+

Service Includes: Thorough consultation before starting service, individualized detailed education on your own hair/scalp type, appropriate product recommendations for your hair and scalp needs, chelating treatment, customized Haircut & Color, signature aroma therapy deep relaxing shampooing experience with scalp and neck massage, blow out styling. (No curling iron or flat iron) Invoice for $55 new client deposit must be paid before I accept the appointment. Please note: First time appointments require more time and attention to details as it is our first time working together.

New Client Lightening / Highlights / Gray Blending with Haircut $620+

New Client Lightening / Highlights / Balayage with out Haircut $520+

Service Includes: Thorough consultation before starting service, individualized detailed education on your own hair/scalp type, appropriate product recommendations for your hair and scalp needs, chelating treatment, customized detailed lightening technique placement and formulation, haircut shaping and or maintenance for the option with haircut, signature aroma therapy deep relaxing shampooing experience with scalp and neck massage, blow out styling. (No curling iron or flat iron) Invoice for $55 new client deposit must be paid before I accept the appointment. Please note: First time appointments require more time and attention to details as it is our first time working together.

New Client Haircut $195

New Client Haircut or High Density Haircut $225

Includes thorough consultation, extra time for high density hair, individualized detailed education on your hair / scalp type, appropriate product recommendations for your hair / scalp needs, signature deep relaxing aromatherapy shampooing experience with scalp and neck massage, educational styling. Non- Refundable New Client $55 deposit invoice must be paid before I accept appointment. Please Note: First time appointments require extra time and attention to details as it is our first time working together.

New Client Curly Cut - $275

New Client Curly Cut - High Density - $300

Includes thorough consultation, specialty curly haircutting technique extra time for high density individualized detailed education on your hair / scalp type, appropriate product recommendations for your hair / scalp needs, signature deep relaxing aromatherapy shampooing experience with scalp and neck massage, educational styling. Non- Refundable New Client $55 deposit invoice must be paid before I accept appointment. Please Note: First time appointments require extra time and attention to details as it is our first time working together.

Color Corrections / Specialty Hair Color- $850+

In person consultation required.

Keratin Treatments - $500 (after hours only)

Hair Extensions - Consultation required

Available upon request:

After hours appointments $75 fee added to service total

Day Off appointment $350 fee added to service total

Working Hours: Sunday 11am-6pm, Monday 11am-6pm, Tuesday 1pm-8pm

There’s a $55 Non-Refundable deposit requirement which will be invoiced to you via email upon booking appointment

All sales are final, no refunds or chargebacks.

Short cancelations after 3 day window will be charged 65% of service total.

No Call, No Shows will be charged 100% of service total. (No exceptions)

If you are unwell showing any symptoms of illness, or last minute emergency situations please reschedule appointment for future date. Non-refundable deposit will be required to hold future appointment.

Please DO NOT show up to your appointment sick.
Canceled appointments (with out rescheduling for future date) due to illness or last minute emergency situations will be charged 65% of service total.

Any unpaid invoices extending the 90 day grace pay period will be sent to collections.

Please plan your appointments accordingly, keep track of your appointment date and time, reach out if you are not receiving confirmation texts /emails.

Showing up late to your appointment may disrupt the entire process. We will do what possible with remaining time. Will be charged the price of the appointment scheduled.

Do not wear your nice clothes to a color service. (Operator is not responsible for damaged or lost goods)

Please arrive to with clean dry hair, styled down as you normally wear. No Buns, Braids, or pony tails. Product is ok. For curly cuts: arrive with natural texture. Failure to do so may add time and cost to your service.

Street Parking is available, download the ParkMoblie app on your phone or be prepared with coins. There is also a parking structure on Locust St.

If you are unsatified with results please contact operator within 2 weeks of service for any complimentary adjustments. Reaching out 2 weeks after service is considered a new service and will be charged full price.

NO REFUNDS OF ANY SERVICES OR DEPOSITS

Once this intake form has been completed, signed and submitted allow 1-3 days for response via email for scheduling (check your spam folder.) If you have not heard from me please text or call (408) 831-1849 or email priscila.sorianohair@gmail.com
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ReleaseI acknowledge that there are risks involved in any hair treatment and use of cosmetic products that may lead to allergic reactions or chemical reactions which may lead to skin irritation, discomfort, or illness. I release with full knowledge and voluntary consent, the Company, its employees, owners, directors, affiliates, the management, and partners from any and all liability, damages, claims, and causes of action arising from any harm, injury, discomfort, damage, or death. Further, I declare that I have no illness or any condition that might give adverse effects from the procedure I will undergo. I have been informed of the necessary precautions that I need to comply with. Operator is not responsible for any lost or damaged items. I declare that I am of legal age or represented by a parent/guardian with full competency to sign this consent. Parent or legal guardian must be present during time of consultation. I agree in accepting the terms and conditions for the services to be performed.
YESNO
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SignatureBy signing this you agree to everything above and can proceed to scheduling appointment. Parent Or Guardian signature / consent is required for anyone under 18 years of age.
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