New Guest Inquiry for Perms

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email* This field is required.
example@example.com
4
What is the best way to contact you?* This field is required.
Text
Email
Phone Call
5
What is your birthday?* This field is required.Gift giving is our love language!
Date
Year
Month
Day
6
Is there a stylist that you prefer to see?* This field is required.Please take a moment to visit our website and check out the "About Us" section. You'll find profiles of each stylist, detailing their specialties. If you're unsure or would like our experts to assist you in finding the right match, simply select "No Preference." We're here to make sure your salon visit is tailored to your needs and preferences.
Please Select
Please Select
Melanie Pace
Courtney Fisher
No Preference
7
What are you currently struggling with the most?* This field is required.
Finding my Signature Style
Dry Hair
Chemical Damage
Hair Loss or Thinning Hair
Frizzy Hair
Lack of Volume
Oily or Greasy Hair
Split Ends
Dull Hair or Lack of Shine
Heat Damage
Styling my Hair
Using Products
Scalp Health
Nothing, I’m happy with it!
8
Please select ALL the services you may need* This field is required.
Consultation
Perm
Wash and Style
Haircut
Corrective Haircut
Transformational Haircut
Single Color Touch Up
Single Color All Over
Mini Touch Up
Partial Touch Up
Full Touch Up
Mini Transformation
Partial Transformation
Full Transformation
Corrective Color
Hand Tied Weft Extensions
Tape In/Medical Grade Adhesive Extensions
Grey Coverage
Grey Blending
Styling Lesson
Vivid/Artificial Color(s)
Scalp Care Treatments
Hair Care Treatments
Self Care Treatments
Formal Styling
Just a Wash!
9
How often would you like to maintain your hair?* This field is required.
Once every 2 weeks
Once every month
Once every 2 months
Once every 3 months
Once every 6 months
10
When was your last professional salon perm service?* This field is required.
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
11
When was your last in home perm?* This field is required.
Never
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
Less than 2 years ago
Less than 3 years ago
Longer than 3 years ago
12
Have you ever had a reaction to perming solutions?* This field is required.
YESNO
13
Current Hair Uploads* This field is required. Please upload 2 - 4 current pictures of your hair in the most natural lightening possible. No filters. Please note - all images uploaded are kept secure, confidential and private to A Signature Salon employees only. We require this to better understand how we can achieve your goals.
Drag and drop files here
Select files to upload
Cancelof
14
Inspiration Hair Uploads* This field is required.Please upload any images that you LOVE and would like your hair to look like.
Drag and drop files here
Select files to upload
Cancelof
15
What days and times are you available?* This field is required.
Mondays
Wednesdays
Fridays
Saturdays
8am - 12pm
12pm - 4pm
After 4pm
I am flexible
16
What is your budget for this appointment?* This field is required.Remember, first time transformational appointments tend to be higher priced than a maintenance or touch up appointment. We are happy to work with your budget to meet your goals efficiently, effectively, and with integrity.
$100 - $200
$200 - $300
$300 - $400
$400 - $500
I have no budget, I just want to achieve my goal right away
I am interested in hair extensions and understand the pricing it entails
17
Is there anything else you’d like your stylist to know?
Huge
Large
Normal
Small
Ok
Ok
18
How did you hear about us or find us?* This field is required.
Should be Empty: