Salon Digital Consultation Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
City, State
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
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
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
How did you find us?Please answer below: (ex. Instagram, Facebook, Google, Rezo Stylist Finder, Ouidad Stylist Finder, Yelp, Referral)
6
Do you have a preferred stylist in mind?
Bernadette
Carmela
Angelina
Caitlin
Jess
No preference
7
Are you looking to book a Customized Curl Cut?This includes any of the following methods for curly cutting: Rëzo, Ouidad, Daze Curl, Forever Curls, & Cadō.
YESNO
8
Check off all the services you think you might need.
Grey Coverage/Retouch
Highlights/Balayage
All over color (roots to ends)
Conditioning Treatment
Product Recommendations/Styling Lesson
Glaze/Toner/Gloss
Brow waxing/tinting
Other
9
If Other, what service are you looking to have done?
10
Image Field
11
Image Field
12
Image Field
13
Image Field
14
Based on the service menu, which service would you like to book?
Let's be Curlfriends $150-$165+
The Curl Experience $200-$220
Color My Curls $227-$262
All Inclusive Transformation $330
Curlyage/Balayage Session $330
Curl Treatment & Discovery $125
Curly Cut (training stylist) $125
Other service not listed
15
Service you wish to book. Please type the service you wish to book below.
16
How would you describe your hair density/thickness?Example: When parting your hair - High Density hair = Scalp barely visible. Low Density = Scalp easily seen
17
Please choose which best fits your length of hair.
Short (Above the shoulders)
Medium (Just below the shoulders.)
Long (Below the bra line)
18
Your hair history the last 2 years.
I have colored my own hair.
I have not colored my own hair.
I have had my hair colored professionally only.
Other, please specify.
19
What are you looking to get done? Is there anything else you would like to share? Example: If you are allergic to anything in particular that might be in a product that we use.
Huge
Large
Normal
Small
Ok
Ok
20
Please verify that you are human* This field is required.
Should be Empty: