New Guest Request Form

Form
New Guest Request Form
Name*

First NameLast Name
Email*
example@example.com
How did you hear about us?*

GoogleInstagramYelpFamily or FriendOther
Referred by*
Which services are you interested in? Select all that apply.*

Hair Loss TreatmentsTreatment for Scalp ConditionReparative treatment for texture issuesVirtual Hair Loss / Scalp Issues Consult (for non-local clients)Color ServicesHaircutsOther
What is your hair type?*

Ultra-fine or ThinFineMedium (neither fine nor thick)ThickExtra ThickOther
How would you describe your hair texture? Select all that apply.*

Wispy / Fly AwayStick StraightWavyCurlyCourseFrizzySlick and ShinyOther
Do you have any filtration system for the water you use to wash your hair?*

Reverse-OsmosisWater SoftenerFiltered Shower HeadNoneOther
Photos of Your Current Hair or Scalp (Pics should be taken in indirect natural light. Hair should be down, brushed, and shown from the front, sides, back, and top.)*

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For Hair Loss Treatment Requests*

I have a medical condition causing hair lossI take a medication known to cause hair lossI am using Minoxidil, Finasteride or other oral medicationI am using a topical treatmentOther
Scalp Treatment Requests - current symptoms. Select all that apply*

Itchiness or SensitivityExcess Sebum (chronic oiliness)Flaking or DandruffBuild-up on the scalpOther
For Color Requests - What are your color goals? Select up to 3 options*

Go lighterGo darkerCover grey - roots only (no highlights)Cover grey - roots to ends (no highlights)Dimensional "lived-in" color (Balayage)Traditional HighlightsOther
For Color Requests - Hair History previous 3 years. Select all that apply*

Colored in salonHighlighted in salonColored at home with box colorOver Tone or other fashion colorsHennaNever ColoredOther
How long has it been since your last color? *
Have an inspo pic of your desired results? Attach them here.

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Is there anything else you would like for me to know?
Thank you for your interest in visiting Wisp Organic Salon! Your request will be reviewed within 48 business hours (Tuesday - Saturday). You'll receive a follow-up email with instructions for booking your first appointment.

IMPORTANT! If you haven't received a response within 48 business hours, please check your spam folder for emails from hello@wisporganicsalon.com.

I look forward to meeting you!

-Sarah
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