HEADSPA INTAKE FORM

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All treatments are custom-tailored to each individuals circumstances and needs! Each customized treatment is perfect for whatever concerns you maybe facing!

Each treatment includes

-a full scalp analysys with live photos
-face, scalp, chest & neck massage
-deep clarifying treatment & scrub to remove oils & product buildup
-detoxifying botanicle scalp treatment/ gentile exfoliation scalp treatment(which one you receive is decided by your specialcist depending on quality of scalp & hair)*
-Scalp steam with restoring hair mask
-Chakra opening Hydro-dhara waterfall treatment**

--IF you have a barber cut / no hair, the hair mask will be replaced with the flowerfall tonic

*Customized Botanicles / scalp exfoliant included in Equinox + Signature Solstice treatment only

**Add-on the flowerfall tonic to your Hydro-dhara waterfall treatment & unwind into total aeromatic relaxation. This treatment will hydrate and transform your scalp and mane to add strength and shine! (+$20)

Blowdrys are discounted at $40 when bundled with any head-spa service.
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Name* This field is required.
First Name
Last Name
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Email
example@example.com
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Phone Number (CELL FOR EASIER COMMUNICATION)* This field is required.Promise we won't spam ya- however can't promise we won't send you love notes :-*
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Have you had a scalp treatment before?
Yes
No
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PLEASE SELECT DESIRED ADD-ON SERVICES if ANYSelect all that apply- CUSTOMIZE YOUR BOOKING HERE
+ ADD on Flowerfall tonic to Hydro-Dhara watefall +$20
Cryotherapy Facial +$35
Scalp stimulating treatment (high frequency comb, product roller...) +$35
I Would like a blowdry with my treatment +40
I would like to switch out my botanicals for an extended head massage (available only to Equinox & Signature Solstice treatments. Not recommend for anyone suffering from dry scalp/ dandruff)
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What are you hoping to get out of your head spa experience?Please select all that apply
Hair & scalp health
Relaxation
Relieve stress in head/neck/shoulders
All the above
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How do you like your pressure?* This field is required.Are you a deep pressure or a light touch kind of person? Let us know so we can best accommodate you!
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Scalp ConditionPlease select all that apply
Normal
Dry
Oily
Dry/flaky
Sensitive/irritated
alopecia
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Tell us a little about your hair* This field is required.please select all that apply. We ask this to ensure we have enough time allocated for your service. If extra time/product is needed to accommodate your appointment, an extra $25 fee per half hour will be added to your total.
My hair is average length and density
I have extensions (sew in, I-tip, k-tip, tape-ins)
My Hair is extra thick (ex: you have trouble getting a second loop around your hair with a hair tie)
My Hair is extra long (over 10" past collar bone)
My hair is very curly/ textured (3/4C)
I'm not sure what my hair would be considered (please attach photo with this option)
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IF you are unsure or have 3/4C hair:If you are unsure if your specialist will need extra time to accommodate your appointment, please provide us with a photo. This step is optional
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What are your main hair & scalp concerns if any?
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Are you suffering from any of the following:
Thinning hair/ postpartum loss
Chemically damaged/ over processed hair
Damaged Hair from heat styling
Breakage from medication / environmental stressors
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Do you have any of the following conditions:Please select all that apply
Psoriasis
Constipation
Clenching of jaw
Migraines/ Headaches
Cancer
Hypertension
Hypotension
Dizziness
Rosacea
Diabetes
Low Libido
Hormonal Imbalance
Blush Easily
Depression/ anxiety
Eczema
Bruise Easily
Brain Fog
Skin Disease
Sleep issues/ insomnia
congestion/ sinus pain
menstrual pain
Other
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If you selected "Other" please explain
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Any known allergies?If yes, please describe below. EX: nut, lavender, eucalyptus, gluten etc… We do use products with nut extract so please be specific so we can accommodate your needs.
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Are you pregnant?
Yes
No
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Are you wearing contact lenses?
Yes
No
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What Size robe would you prefer?We will allocate your preferred size in a locker for you
Please Select
Please Select
one size (fits size S-L)
XL
XXL
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Have you had any neurotoxins/ injectables in your face within 48 hours (of treatment date)* This field is required.ex: Botox, fillers, PRP
YESNO
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Have you undergone any surgeries we should be concerned about today that could be affected by your treatment?* This field is required.
Yes
No
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Photography/ videography consent* This field is required.At times we will take photos/videos of your treatment being performed for social media. Please select below if you consent to your service being documented. We always keep in mind angles/modesty and would never post something of you we would not post of ourselves.
Yes, I consent
Yes, I consent but keep my identity hidden
No, I do not consent to any photography/ videography
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Additional NotesPlease provide us with any extra specifics to better customize your treatment experience
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I understand that my data will be strictly confidential. ALOBLOW Dry Bar does not sell, share, or resell information.

I confirm that all information in this form is true and accurate.

I agree that if I withhold some important information and complications happen, ALOblow & my treatment specailist will not be liable.

I release ALOblow & staff, and hold harmless against any claims, expenses, damages, and liabilities.
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Please read thoroughly:

Treatment disclaimer: We ask for each client to arrive 5-10 minutes prior to their appointment time. During your treatment you will receive a facial and neck massage, along with your scalp & head massage. In preparation for your appointment, we ask that you arrive with no makeup or necklaces. If you arrive with makeup on, and would like it removed, we will happily remove it for you before your treatment. Please note this extra time may be deducted from your treatment time if your specialist is booked back to back or may result in an additional charge for time. We will also have a locker for you to place your belongings and jewelry if you would like to remove it before your treatment. If you do not wish to remove your makeup or would like to skip the facial massage, please let your provider know ahead of time.

If you are coming with a friend or group, we do ask that you are respectful of others receiving their services once your headspa is completed and keep your volume low when chatting with each other in the lobby/ blow dry bar area.
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This treatment is not done in a private room. We have a privacy wall that separates you from the rest of the salon, but still in an open space. We want to manage expectations by reminding you this is not a full body massage that is meant to be performed in a private room. It is first and foremost a treatment meant to heal and deep cleanse your hair and scalp. We offer disposable ear buds if you'd like to dull the background noise of the salon. If you choose to not use the ear buds, You will be subjected to the sound of light salon chatter and other services happening in the background. We do strive to keep the environment as quiet and relaxing as possible, however, there are other services being performed. The option to also play music in your own earbuds is available. This is a popular option amongst our clients. We can assure you no water damage will happen to your earbuds.* This field is required.I have throughly read & understand the treatment disclaimer
YESNO
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Cancellation Policy & deposits:

A $50 non-refundable deposit will be automatically charged to card entered at booking. This deposit will be deducted from your total at the completion of your services.

A minimum 48-hour notice is required to cancel or change any appointment. Cancellations made outside the 48 hour window will not need to make another deposit to re-book. Deposit will be held and can be used towards any future appointment.

Appointments canceled/rescheduled after the 48-hour notice period, will lose their deposit & will be charged 50% of the remaining total of scheduled services. Another deposit will be required to re-book.
Reschedules or cancellations made within 24 hours of scheduled appointment & no-shows will be charged 100% of total services. Card on file will be automatically charged.

We understand that life happens and sometimes you need to cancel due to an emergency. We do our best to give grace in these situations, but do track all late cancellations and no-shows in order to ensure our policies are not abused.

Late Fees: ALO has a 15 minute grace period, as most specialists are booked with appointments the whole day. After 15 minutes, you may be asked to reschedule and a no-show fee will be applied. Please know that if you are running late, and your specialist is booked after you with another appointment, this time will be deducted from your treatment.

PLEASE NOTE: If you cancel last minute due to COVID, we will happily waive the cancellaton fee if you choose to provide a valid, positive COVID test. If you choose not to provide a valid test, a late cancellation fee will be applied.
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Terms and Conditions* This field is required.
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SignatureI have answered all above questions to the best of my ability
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