New Guest Intake Form
Hey! It’s time to lock in your first appointment with me, and I can’t wait to vibe with you! ✨ Before we can make some magic, I do need a bit of info from you—it’s mandatory so I can make sure everything’s set for your experience to be top-notch. 🌿 Once you’ve got that handled, you’ll get all the deets to secure your spot. Follow the steps, and we’ll be all set to create something amazing together! ✂️💫
Name
*
First Name
Last Name
Guest’s Email
*
example@example.com
What are your Pronouns?
*
She/Her/Hers
He/Him/His
They/Them/Theirs
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guests Number
*
Please enter a valid phone number.
Sign up for SMS
*
You agree to receive transactional messages. Terms and Policies can be found at act-on.com/privacy-policy/. You may receive up to 5 msg/month. Text and data rates may apply. Reply STOP to end or HELP for help.
• Sign up for SMS • You agree to receive transactional messages. Terms and Policies can be found at act-on.com/privacy-policy/. You may receive up to 5 msg/month. Text and data rates may apply. Reply STOP to end or HELP for help.
*
Date of Birth
*
.
Month
.
Day
Year
Date
Emergency Contact Information
First Name
Last Name
Emergency Contact Phone #
*
Please enter a valid phone number.
Emergency Contact Email
example@example.com
Your Relation to Emergency Contact
*
Ex: Partner, Sibling, Parent, Child
Submit
Should be Empty: