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Eclectic Appt Request
Please take a moment to fill out this form to request an appointment at Eclectic Hair Studio. It should take you less than a minute. A member of the team will be in contact via text within 48 business hours.
13
Questions
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1
Your Name
*
This field is required.
First Name
Last Name
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2
Email
*
This field is required.
example@example.com
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3
Cell Phone Number
*
This field is required.
Area Code
Phone Number
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4
By entering your email address and phone number, you agree to receive automated promotional messages. This agreement isn't a condition of any purchase. Msg&Data rates may apply. Opt out at any time. Reply STOP to end or HELP for assistance.
*
This field is required.
I agree and consent to receive messages and emails
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5
Service(s) Requested
*
This field is required.
Select all that apply
Extension Move Up + Color
Extension Move Up Only
Dimensional Color (Balayage, highlights, etc)
Add on - Base color between balayage/foils
One Color All Over OR Gray Root Retouch (No highlights/blonding)
Add on - Haircut with Color, Brazilian Blowout or Extensions
Add on - Brow Wax
Add on - Conditioning Treatment
Eyelash Extensions - Full Set
Eyelash Extensions - Fill
Brazilian Blowout
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6
Stylist(s) Requested
*
This field is required.
Please select all that apply
Angie
Belle
Shylee
The most experienced
The most affordable
I'm happy with anyone
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7
Days Available
*
This field is required.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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8
Times Available
*
This field is required.
You can be to Eclectic by - Color services usually last 2-3 hours. NBR+Color usually lasts 3-5 hours.
7am
8am
9am
10am
11am
12pm
1pm
2pm
3pm
3:30pm
4pm
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9
Specific Date Requested
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10
Do you need in ASAP?
*
This field is required.
YES
NO
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11
If you're planning to make a change to your current color, please explain what you're wanting to do
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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12
Here's a spot for you to upload an inspiration picture. If you want, screenshot a picture of what you want your hair to look like... Instagram and Pinterest are great places to look for inspiration if you're wanting a change. You may text this to 740-633-2507
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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13
Here's a spot for you to upload a picture of your current hair. This is REQUIRED if you are a new guest or haven't had an appointment with Angie in 6+ months. We don't need to see your face, but we do need a clear view of your hair so we can get you scheduled for the appropriate amount of time. You may text this to 740-633-2507
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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