New Guest Form
Welcome to Michael Helene Salon Gallery! We are so excited for you to come in and allow us to play with your hair! In order for us to give you the best experience in a salon, we do require that you fill out this form below. We just need a little information about you, your hair and previous hair and medical history.
Name
Your answer
Name of Parent/ Guardian (if a minor)
Your answer
What is your Date of Birth?
MM
/
DD
/
YYYY
Address
Your answer
City, State and Zip Code
Your answer
Telephone Number
Your answer
Would you like to receive reservation reminders via text message? If yes, please add your phone carrier. (ex. verizon, AT&T etc.)
Your answer
Email Address
Your answer
Would you like us to enter you in our complimentary rewards program, TapMango?
Are you currently undergoing treatment or taking medication?
If yes, please specify what treatment and/or medication you are on.
Your answer
Do you have an know allergies to the following:
Required
If you are allergic to anything that was not specified above, please list what you are allergic too below:
Your answer
Are you pregnant?
If you are pregnant, how far along are you?
Have you recently had a baby?
If you have recently had a baby, how long ago?
Do you suffer from a sensitive scalp?
What previous chemical services have you had in your hair? (please check all that apply)
Required
How often do you visit a hair salon?
From the following statements, which would you say most reflects your lifestyle?
How did you hear about us?
If a friend, family member or co-worker referred you, what is their name?
Your answer
At Michael Helene Salon Gallery, we enjoy taking before and after photos of our work, in order to build our artist's portfolios and advertise on our website, ads and other platforms. Do you consent to having your photo graph taken?
If you are a minor (17 and younger), do we have your parent's consent to take your photo for portfolio building and advertising purposes?
Cancellation Policy: Please arrive to your reservation on time. Late-comers may be asked to reschedule. If you need to cancel, please give 24 hours notice, otherwise you may be charge for your missed reservation. No shows will be charged 50% of the scheduled reservation. Cancellations within 12 hours will be charged 20% of your scheduled service fee. If you do not show up for your scheduled reservation, it takes time away from others, as well as your artist. We work off of commission so as we try to respect your time, we ask that you do the same for us. If you do have an emergency, just let us know! We understand things come up last minute, but please let us know as soon as possible or you may need to pay your fee before scheduling another reservation. You may also be asked to leave a credit card number if if becomes a reoccurring issue in order to hold your reservation.
Required
I hereby certify that the information given and completed on this New Guest form is true and correct to the best of my knowledge. I understand that the salon will not accept any liability if the information I have provided is incorrect.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms