Welcome to The Self-Care Circle — a pay-it-forward program by The Ritual Co. that provides complimentary salon and spa services to community members in need. Please complete the form below. All responses are confidential.
APPLYING OR NOMINATING?
Are you applying for yourself or nominating someone else?
Applying for myself
Nominating someone else
Your Name
First Name
Last Name
Your Email
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Your Relationship to the nominee
Contact Info
Name of the person who will receive the service
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Service Needs
Which service would benefit you/the nominee the most right now?(check all that apply)
HAIR
SCALP TREATMENT
SKIN/FACIAL
MASSAGE
BROWS/LASHES
BODY TREATMENT
I'M NOT SURE, PLEASE CHOOSE FOR ME
Is there a specific reason this timing matters? (optional)
Personal Story Section
What have you/they been experiencing that has made self-care difficult?How would receiving this service support you/them?
Eligibility + Barriers
Have you/they received a professional salon or spa service in the last 6 months?
YES
NO
Are there financial or personal barriers preventing you/them from booking a service?
YES
NO
If yes → “Please share a brief explanation (optional).”
Participation + Scheduling
If selected, are you /they able to attend a scheduled appointment?
YES
NO
I NEED FLEXIBLE SCHEDULING
Do you / they agree to provide at least 24-hour notice if you need to reschedule
YES
NO
Comfort Considerations
Is there anything we should know to make your/nominee's appointment more comfortable?(sensory needs, trauma-informed preferences, mobility concerns, etc.)
Do you give permission for The Ritual Co. to contact you or nominee by text or email?
YES
NO
Optional Feel-Good Questions
What is something you wish others knew about you /them right now?
What recent win (big or small) are you/them proud of?
What makes you/this person deserving of support through The Self-Care Circle?
Save
JOIN THE CIRCLE
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