Waitlist Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address City State Zip Code Occupation(Required) Birthday(Required) Allergies(Required) Preferred Appointment Date and Time(Required) How did you hear about me?(Required) Common hair products used:(Required) What do you like and dislike about your hair?(Required) When was your last salon visit?(Required) What type of service are you inquiring about? Check all that apply:(Required) Haircut Color/ highlight Treatments Facial waxing/ brow shaping Other How would you describe your professional style?(Required) Corporate Business casual Creative Casual How would you describe your personal style?(Required) Classic Modern Trendy Natural What are your hair goals?(Required) Subtle change once a year Change with the seasons Have a major change in mind Love to change every visit Maintain a specific style How often do you commit to salon visits?(Required) 1-6 weeks 7-12 weeks 3-6 months Once a year On average, how long does it take to style your hair at home?(Required) Less than 15 minutes 15-30 minutes 31-45 minutes More than 45 minutes How do you style your hair?(Required) Air dry or lightly diffuse Blow-dry with a flat brush Blow-dry with a round brush Blow-dry with a brush and hot iron How comfortable are you when styling your own hair?(Required) Uncomfortable Comfortable Very comfortable Would like guidance How long is your hair?(Required) Short - above ears Short to mid - above my shoulders Mid - shoulder length Mid-long - past my shoulders Long - mid back or longer How would you describe your hair's abundance?(Required) Sparse Average Thick How would you describe your hair?(Required) Straight Wavy Curly Kinky What is your hair's condition right now?(Required) Normal Dry Distressed Porous What is the condition of your scalp?(Required) Dry Oil Acne Other What is the reason for your visit?(Required) I am not in LOVE with my current hair color/cut My hair is damaged and I need help/ I am looking for hair care recommendations I am just visiting and need my hair done. I like it how it is, just need a touch up. I am happy with my hair, just need a new stylist. Why are you looking for a new hairstylist?(Required) I felt like my previous stylist was not listening to me/ did not pay attention to me My stylist moved and I am devastated and desperate I am new to the area and was referred to you/ found you online I have never liked my hair Other Where did you move here from?(Required) Would you be willing to pay a 30% overtime fee if you need to see me outside of my standard salon hours or request a longer appointment time?(Required) Yes No I am not just looking for another hairstylist, but a hairstylist who personalizes my appointments, educates me on my own personal hair, how and what I should use to maintain it at home, teach me new styling techniques and what is possible and safe/ healthy for my hair. I'm looking for a hairstylist who customizes color/treatments/cuts/etc. I am looking for recommendations based off of my dream hair and what will work for my own personal needs for the number of visits, the amount of time for appointments and how often I can maintain my new look.(Required) Yes No I understand that by submitting this form I will be put on a waitlist and that I am not guaranteed an appointment with Eileen.(Required) Yes No I have read and agree to the policies stated below.(Required) Agree Do not agree Upload a recent photo of your hair.(Required)Max. file size: 256 MB.Upload any inspirational photo you may have.(Required) Drop files here or Select files Max. file size: 256 MB. PhoneThis field is for validation purposes and should be left unchanged.
