Head Spa Intake 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.
Area Code
Phone Number
4
How'd you find Flourish Curl Studio?* This field is required.
Please Select
Please Select
Instagram
Google
From a friend
Local business
Met in person
Other
5
Based on the service menu, what package would you like to book?* This field is required.
Head Spa: The Mini ($115)
Head Spa: Halo Treatment ($175)
Head Spa: Full Halo & Facial ($215)
Head Spa: Wellness Ritual ($250)
6
Have you had a head spa service before?
YESNO
7
How would you describe your hair?Select all that apply
Fine
Thick
Coarse
Dry
Frizzy
Thin
Silky
Dull
Greasy/oily
Limp
8
How long is your hair?* This field is required.
Pixie/partly shaved/very short
Short (above shoulders)
Medium (shoulders or upper back)
Long (Mid back or lower)
9
Do you suffer from any of the following?Select all that apply
Psoriasis
Eczema
Oily scalp
Dry scalp
Thinning hair
Excessive hair loss
Build up on hair or scalp
Flaky scalp
Itchy/sensitive
None of the above
10
Are you currently taking any medications or supplements that may negatively or positively impact your hair or scalp?
YESNO
11
Please select any of the following that apply to you
Headaches or migraines
Pregnant
Neck or shoulder pain
Chronic pain
Sprains or strains
High/low blood pressure
Numbness
Sensitive scalp
None of the above
12
Would you prefer a silent appointment or would you like a step by step explanation of the service steps?
Silent appointment
Step by step explanation
13
What kind of pressure do you prefer?
Light
Medium
Deep
14
How stressed are you?
Very stressed
Medium/average stress
Low stress
15
Do you have any allergies or sensitivities to essential oils or certain scents?
YESNO
16
What kind of head spa experience would you like to have?* This field is required.
Deep relaxation and stress relief
Therapeutic and educational
A little bit of both
17
Are there any specific concerns or goals you’d like to see from this treatment?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
18
IMPORTANT: PLEASE READ BEFORE SUBMITTING*

Upon submitting this form, you will be redirected to our online booking site to request your preferred appointment date and time. Please note that submitting this form does not complete your booking request.

BOOKING INSTRUCTIONS

Step 1: After being redirected to the booking site, you'll find the service menu. Please navigate to the category labeled "Head Spa Services".

Step 2: Choose the service you wish to book.

Step 3: Follow the prompts to finalize selecting your desired services.

Please Note: If this is your first time with us for a head spa sevice, please select one of the Halo Treatments in order for us to have enough time for a full scalp evaluation.

Once your booking request is completed, you will receive an automated confirmation via email or SMS, based on your preferences. Kindly note that this booking is a request and will be either confirmed or denied within 48 hours. If you do not receive any confirmation notifications, your booking has not been successfully completed.

Should an incorrect service be booked, you will receive a follow-up email with guidance on how to correctly book your appointment. Please be aware that appointment requests are subject to approval.

If the services you desire do not align with Love's specialties, we may be unable to accommodate your appointment (please understand it’s nothing personal), and we will gladly provide you with alternative salon recommendations in the area.

Thank you for your understanding, and I truly look forward to connecting with you!
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