EmailMe Form - ECS: HAIR SMOOTHING (KERATIN) CONSULT FORM

ECS: HAIR SMOOTHING (KERATIN) CONSULT FORM

Please Note: Appointments for Hair Smoothing (Keratin Treatment services are currently available Tuesdays and Thursdays - Saturday by Appointment only.
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What is a Hair Smoothing (Keratin) Treatment?

Keratin treatments are used to tame frizzy hair. A keratin treatment will not permanently straighten your hair, but it will smooth it, add shine and manageability.

The Hair Smoothing (Keratin) treatment process takes approximately 2 - 4.5 hours depending on the client's hair length, texture and requested Keratin system and product usage. Please be mindful of this when scheduling.
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HAIR SMOOTHING (KERATIN) TREAMENT ONLINE PRE-SCREENING is complimentary.

HAIR SMOOTHING (KERATIN) IN-PERSON PRE-SCREENING costs $35. The Pre-screening Fee is non-refundable and non-transferable. The In-Person Pre-Screening fee is NOT deducted from the total cost of the Hair Smoothing (Keratin) service.

NOTE: THE IN-PERSON PRE-SCREENING FEE MUST BE SUBMITTED BEFORE COMPLETING THIS FORM.

IF THE IN-PERSON PRE-SCREENING FEE IS NOT SUBMITTED PRIOR TO THE SUBMISSION OF THIS FORM, THE FORM WILL NOT BE REVIEWED.

Copy & paste our link in your web browser to submit the $35 Pre-screening fee:

https://bit.ly/PERMSCREEN
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Complete the Consultation form below to begin the Hair Smoothing (Keratin) Treatment process. Should you need assistance or have a burning question, EMAIL US at appointmentdesk@endlesscreationssalon.com, TEXT US at 480-485-4413 or CALL US at 480-269-7542 (leave a voicemail).

PERSONAL INFORMATION
Name *
First Last
Email *

Confirm
Contact Phone *
### - ### - ####
Home or mobile number, whichever is best to reach you.

Confirm
### - ### - ####
What is the age of the person receiving the Hair Smoothing service? *
Under 30
In my 40s
In my 50s
In my 60s
In my 70s
In my 80s
In my 90s
If, UNDER 30 list exact age
What is the occupation of the person receiving services? *
Ex. Student, Retired, Nurse, etc.
HOW DID YOU HEAR ABOUT US? *
Current Client
Facebook
Google Search
Google Reviews
Instagram Page - Endless Creations Salon
Instagram - Specific Stylist Page
Internet Search
Referral
Other
CLIENT STATUS
Name of the person receiving a Keratin Treatment: *
First Last
I am scheduling a Hair Smoothing (Keratin) Treatment for: *
Myself
My Child
My Grandchild
Friend
Other
I am a *
New Client (1st Visit)
Welcome Back Client (6+ months since last Visit)
Visiting Client (Out of Town)
Other
Visiting Client: Please list your current City and State *
Type N/A if this does not apply to you
Gender Identity of the person receiving services *
Male
Female
NON-BINARY
HAIR TEXTURE - TYPES - DIFFERENCES
What is your Ethnicity? *
Caucasian
African American
Asian
Bi-Racial
Hispanic
Indian
Other
This will assist us in assessing your hair type.
My Hair Texture is: *
Coarse
Coily
Curly
Fine
Kinky
Kinky-Curly
Medium
Wavy
Other
Please select the option that best describes your hair texture
What is your degree of curl?: *
Curly
Tight Curl
Coily
Wavy
Kinky
Kinky-Curly
Spiral
Other
Please select the option that best describes your hair texture
CURRENT HAIR CONDITION
My hair length is: *
Extra-short: Above chin/nape
Extra Short: between nape & mid neck
Short: Touching shoulder & above
Med-Long: Below shoulder
Long: Touching shoulder blade
Extra-Long - Below Shoulder Blade
Extra-Long: below shoulder blade
Extremely Long: below bra-line to 2 inches
Extraordinary Long - Waist Length to 2 inches
Extraordinary Long: waist length to 2 inches below
LENGTH
- Your hair must be at least 4 inches long to receive this service.
- Pricing on services rendered can and will be adjusted based on appropriate Length, Density (thickness), and Product usage upon check-out.

LENGTH IS DETERMINED BY THE NATURAL LENGTH OF HAIR WHEN THE HAIR IS STRETCHED OUT (ELONGATED).

NOTE: Curly & Coily Textured hair grows big before it grows long.
When the curly & coily textures are stretched out fully the true length of the hair is revealed.

Please select the correct length as pricing will be adjusted based on actual length at the time of service.
Is your hair shedding more than it should be? *
Yes
No
If yes, please explain
Is your hair breaking more than it should be? *
Yes
No
If yes, please explain
Is your hair getting thinner than it should be? *
Yes
No
If yes, please explain
Does your hair become knotted? *
Yes, Sometimes
All the time
No, not at all
Not often
If yes, please explain
Do you feel like you’re shedding more than usual lately? *
No, seems normal
Sometimes it seems to shed more than usual
Yes, lately it has been shedding alot
If yes, please explain
HOW OFTEN DO YOU SHAMPOO YOUR HAIR? *
Every day
Once a week
Every other week
2-3 times per week
Once per month
Other
What’s your conditioning regime? *
Deep Conditioner no heat
Deep conditioner with heat (dryer or steamer)
Quick conditioner (rinse off in a few minutes)
Leave - in conditioner
No conditioner
Other
Please list Shampoo(s) and Conditioners you currently used at home *
Please list Treatment(s) you currently use at home *
Explain your hair care and conditioning regimen? *
How Often do you straighten, flat iron, or use heat to style your hair? *
Daily
Every other day
3x a week
2x a week or less
Other
Would you say your hair is heat-damaged, or your natural texture is compromised due to flat ironing, blow drying or any other heat-styling? *
Yes, part of my texture is compromised
No, my texture is intact
I’m unsure
Other
When was your hair last chemically straightened *
Never
3-6 MONTHS AGO
ABOUT 1 YEAR AGO
ABOUT 2 YEARS AGO
Other
Keratin Treatments can be applied to Chemically Treated hair.

We need your chemical history to determine a suitable Keratin service.
How porous is your hair? *
HIGH POROSITY - hair dries quickly and is frizz-prone; products are absorbed quickly.High porosity- (cuticle layer is highly raised and hair tends to dry quickly)
MEDIUM POROSITY - the cuticle is half-way open, which means that moisture can reach inside the hair shaft quite easily
LOW POROSITY - Low Porosity the cuticle layer tends not to be raised, hair dries slowly and products may sit on the strand instead of absorbing.
Other
Where would you rate your hair on the oily/dry spectrum? *
Roots receive oil easily, while mid shaft and ends are balanced
Roots and mid shaft are naturally balanced but ends are dry
Roots are dry as well as mid shaft and ends are dry
Other
When was your last haircut? *
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
More than one year ago
Other
When was your last trim? *
Less than 3 months ago
Less than 6 months ago
Less than 1 year ago
More than one year ago
Other
What works, and what’s not working for your hair? *
CURRENT SCALP HEALTH
Is hair loss a genetic issue in your family? *
Yes
No
I am not sure
Is your scalp itchy or flaky? *
Yes, Itchy
Yes, Flaky
Yes, Itchy and Flaky
No
I am not sure
CURRENT HEALTH
Are you currently pregnant or have given birth in the past year? *
Yes
No
Have you gone through menopause or could be pre-menopausal? *
Yes
No
Have you had any surgery that required general anesthesia in the past year? *
Yes
No
Do you take any prescription medication? *
Yes
No
Please list any known allergies *
List all current Medications. If no medication, type N/A *
HAIR DENSITY
How dense is your hair? *
Yes, I can see a lot of my scalp
I can see a bit of my scalp
No, I can't see my scalp unless I pull the two sections of hair apart
Other
If you look at the top of your head, where your parting is, can you see your scalp?
SELECT THE CORRECT HAIR DENSITY. What is your actual Hair Density? *
Circumference of up to 3 inches
Circumference of up to 3- 4 inches
Circumference of 4 inches
Circumference of 5 inches
Circumference of 6 inches
Circumference of 7 inches
Circumference of 8 inches
Circumference of 9 TO 10 inches
Circumference of 11-12 inches
Circumference of 13 and up
FOLLOW THE INSTRUCTIONS BELOW FOR AN ACCURATE READING
- Place your hair into a ponytail.
- Wrap a flexible tape measure around your ponytail (this reveals the circumference of your ponytail.

HD - High Density Hair requires more time and product usage.

This helps us to QUOTE CORRECT pricing and allocate and anticipate the amount of time your Hair Smoothing (Keratin) Treatment service may be.
HAIR SMOOTHING (KERATIN) TREATMENT & ANTI-FRIZZ PRICING

Final Price depends on length and density
HAIR SMOOTHING (KERATIN) TREATMENT - SPECIALTY SERVICE DEPOSIT REQUIRED FOR BOOKING - $55 Link listed below. *
BRAZILIAN BLOW OUT | [$175 - $375]
BRAZILIAN BLOWOUT | TWEEN [$140 - $340]
DE STS - KERATIN TREATMENT | ADULT [$120 - $250]
DE STS - KERATIN TREATMENT | TWEEN AGES 6-12 YRS [$110 - $230]
KERATIN COMPLEX EBO - EXPRESS BLOW OUT | ALL [$75 - $120]
KERATIN COMPLEX PBO | ADULT [$175 -$395]
KERATIN COMPLEX PBO | TWEEN (ages 6-12) [$150 -$325]
MIZANI THERMASMOOTH | ALL [$95 - $180]
SILKOUT TAMING TREATMENT | ADULT [$200 - $400]
SILKOUT TAMING TREATMENT |TWEEN [$140 - $340]
PLEASE SELECT THE REQUESTED KERATIN TREATMENT.

PRICE RANGES ARE LISTED. VISIT OUR ONLINE BOOKING SITE FOR DETAILED PRICE
DESCRIPTIONS.

This deposit goes toward the FINAL payment on your reserved appointment day.

ALL HAIR SMOOTHING (KERATIN) PRICING IS BASED ON LENGTH, DENSITY AND PRODUCT USAGE.
HAIRSMOOTHING (KERATIN) GOAL
What is your desired Finishing Keratin result? *
Curl Definition - I want to keep my curls, but reduce volume
Frizz Control - 30 - 40 % Curl Reduction
Ultimate Smoothness - 70 % Curl Reduction
Maximum Straightness - 90 % Curl Reduction
Temporarily Straight for about 1 month
To have a Keratin Reparative Treatment to Restore my hair
Undecided, I need an in-person consultation
If you need an in-person consultation, TEXT US to book an In-Person Keratin Consultation @ 480-485-4413.
HAIR HISTORY
Please be honest. Our goal is to address your hair care issues and suggest appropriate remedies
Is your hair color-treated? *
Yes, my hair is colored but not lightened
Yes, my hair is lightened
No, my hair is its natural color without any enhancements
If any part of your hair has been lightened or darkened from your natural color, answer yes.
When was your last Professional Salon Visit? *
Please provide a list of any chemicals used (e.g. relaxers, henna, keratin treatments, hair coloring and volume of developer used, highlights, texturizers, etc.) used on your hair in the last 5 years along with the date. * *

TREATMENT + DATE mm/dd/yyyy

TREATMENT + DATE mm/dd/yyyy

TREATMENT + DATE mm/dd/yyyy

TREATMENT + DATE mm/dd/yyyy

TREATMENT + DATE mm/dd/yyyy

RELAXER, TEXTURIZER, CURLY PERM, KERATIN TREATMENT, COLOR, HIGHLIGHTS, ETC.

TYPE N/A IF NOT APPLICABLE
PHOTOS

SUBMIT A RECENT PHOTO OF YOUR HAIR IN IT’S NATURAL STATE

Please upload 4 photos of your hair.

1. Front
2. Back
3. Right Side
4. Left Side

Take the photos in front of a white or light colored wall in a white or light T-shirt (for easy visibility).

ALL PHOTOS MUST BE NECK UP *

Add File

IN SALON PHOTOS
- Please note that photos/videos of the hair and your face will be taken for Hair Goals Growth journey and/or promotional purposes.

ALTERNATE PHOTOS SUBMISSION:
If your photo files are too large to send using this consultation form, please fill out an e-mail to appointmentdesk@endlesscreationssalon.com

After reviewing the photos and based on your requirements from the consultation form we will send you a quote and be able to answer your questions on a personal level.
Please upload photos of how you want your Hair Smoothing (Keratin) Treatment to look like *

Add File
HAIRSMOOTHING (KERATIN) GOALS
What would you like to change about the texture of your hair? What is most important to you? *
Improve Manageability
Reduce Frizz
Decrease Blow-Dry Time
Smooth Texture
Soften Curl Pattern
Reduce Volume
Add Shine
Versatility between Straight & Curly Styles
Hair Growth
Other, Please describe
If you need an in-person consultation, TEXT US to book an In-Person Keratin Consultation @ 480-485-4413.
Please describe as thoroughly as possible in your own words your desired Keratin results. *
Would you like to add-on other services to your Hair smoothing (Keratin) Treatment service? *
Olaplex, Trim, HairCut, Semi or Demi Color, etc.
YOUR AVAILABILITY
How soon would you like your Hair Smoothing (Keratin) service? *
ASAP - TODAY WOULD BE GREAT
3-5 WEEKS
SOMETIME THIS MONTH
SOON - WITHIN THE NEXT WEEK
WHAT IS THE BEST DAY FOR AN APPOINTMENT? *
SUNDAY
MONDAY
TUESDAY
THURSDAY
WEDNESDAY
FRIDAY
SATURDAY
LIST MORE THAN ONE DAY HERE
HAIR SMOOTHING (KERATIN) TREATMENT SCHEDULING
Appointments for a Hair Smoothing (Keratin) services are currently available on Tuesdays, Thursdays, Fridays and Saturdays.

If you would like to schedule your Hair Smoothing (Keratin) service on an alternative day and/or time a $75 convenience fee is required.

You can REQUEST AN APPOINTMENT. Use the comments box below to specify the
1. Preferred date
2. Preferred time
3. Preferred Keratin Service
3. Requests or restrictions
4. Add-On services
5. Any other information that may be helpful in booking your appointment.

We will then try to accommodate your request
based our current availability.

If there is no availability of the date/time you requested, we will TEXT or EMAIL you with alternatives and/or offer to add you to OUR PERMANENT WAVE WAITLIST.
HAIR SMOOTHING (KERATIN) TREATMENT RESCHEDULING
If there is no availability when you requested, we will TEXT or EMAIL you with alternatives and/or offer to add you to OUR WAITLIST

You must reschedule at least 48 hours prior to your appointment time. NOTE: THE DEPOSIT IS STILL NON-REFUNDABLE.

If you cancel 48 hours before your initial appointment, you may transfer your Deposit ONE
TIME towards a new date within the next 14 days based on our availability.

If you are unable to come in within the 14 days, you will forfeit your deposit and another deposit will be required for a new booking.
HAIR SMOOTHING (KERATIN) TREATMENT CONVIENCE APPOINTMENT SLOTS
Convenience appointments are appointments outside of regular Permanent Wave operating days and hours.

Specialty Hair Services – Early Bird (Between 5AM -7AM |Late Owl (After Close) | Sundays and Mondays Convenience Fee: $75

LEAVE ALL APPOINTMENT DETAILS IN COMMENT BOX
HAIRSMOOTHING (KERATIN) TREATMENT COMMENT BOX *
Anything else you want us to know

We reply to you VIA EMAIL within 1-3 business days - to see if you are a qualified candidate to receive this service and to provide you with a personalized quote.
FLEXIBLE PAYMENT OPTIONS

Flexible Payment Plans Available

We are pleased to offer our clients a convenient way to pay for all their treatment need.
Select which payment option works best for you. *
Pay my Hairsmoothing (Keratin) Treatment Specialty Service deposit & pay my balance on the day of service upon arrival
Pay half of my service now and pay the remainder balance on the day of service upon arrival
Pay Full Price now
We offer multiple payment options to help with the cost of your Hair Smoothing (Keratin) Treatment service.

Text our Client Service Coordinator (Jay) at 480-485-4413 and request Deposit OR Payment Link.
CONSULTATION PURPOSE
The purpose of this Consultation is to make your Hair Smoothing (Keratin) Treatment service is as successful as possible.

We are looking for length, condition, texture and previous chemicals in the hair. Be as honest and thorough as possible to prevent any adverse reactions to this Keratin service.
HAIR SMOOTHING (KERATIN) TREATMENT DEPOSIT
A Hair Smoothing (Keratin) Treatment service is considered a Specialty Appointments and a $85 - $95 non-refundable, non-transferable deposit is required to hold an appointment slot. The deposit will go towards your final bill.

COPY & PASTE our Hair Smoothing deposit link in your web browser to submit the Deposit:

https://bit.ly/KERATINDEP

ADDITIONAL PAYMENT OPTIONS
- CASHAPP: $MSCECEFOXX
- VENMO ID: @MSCECEFOXX
- ZELLE: mscece@endlesscreationssalon.com

Upon submission of your deposit, please send a screenshot of your confirmation page to our Textline at 480-485-4413 to finalize your booking request
HAIR SMOOTHING (KERATIN) TREATMENT FINAL PAYMENT
Final payment is due UPON ARRIVAL the day of your Hair Smoothing (Keratin) Treatment appointment.
HAIR SMOOTHING (KERATIN) TREATMENT CANCELLATION NOTICE
WHAT IF I NEED TO CANCEL?
Cancellations, Modifications and/or Rescheduling must be completed at least 48 hours prior to the scheduled appointment time
HAIR SMOOTHING (KERATIN) TREATMENT LATE ARRIVAL
LATE ARRIVAL
Any client who is more than 15 minutes late to their appointment AND will are still able to service you WILL BE charged a $25.00 additional fee.

If you are more than 20 minutes late this could result in having to reschedule.

NOTE: This is a lengthy Specialty service, and we block out 3-4 hours for this service
HAIR SMOOTHING (KERATIN) TREATMENT PREP:
- Be prepared! Have a few realistic options for your hair goal.
- Wash your hair 1-3 days before. Hair should NOT be excessively dirty, sweaty or oily.
- Arrive with MINIMAL TO no products on your hair before your appointment.
- Ensure your hair is Detangled (Comb-able from Root to Ends)
– If you are just removing braids, twist, extensions, etc. after an extended period of time, Shampoo, Condition and Detangle and Blow dry your hair before your appointment.
- If you have split ends or it has been more than 4 months since your last trim. We recommend adding a Cut or Trim to your service.

It is best to trim your hair along with your Hair Smoothing Treatment service to ensure smooth defined ends.

- Do not wear your favorite piece of clothing/jewelry!

- Pack a snack! ECS provides beverages and light snacks. Hair Smoothing (Keratin) Treatment appointments can last 2-5ish hours.

- Factor in at-home hair care to your salon visit budget. We do our part to make your hair looks amazing, however as soon as a client walks out the door it is the client's responsibility to maintain their investment!

Salon quality Keratin Shampoo, Conditioners and Keratin maintenance products are highly recommended for optimal results.

- Budget for good products! There are products specifically designed to preserve and prolong Keratin Treated hair.

Before committing to a Keratin Treatment service, we recommend that you take into account the cost of good products to maintain your Keratin treated hair.
HAIR SMOOTHING (KERATIN) TREATMENT RECOMMENDATIONS FOR DAMAGED HAIR CLIENTS
If your hair is not suitable for a Hair Smoothing (Keratin) Treatment at this time we will recommend a Hair solution plan to prepare your hair for a Keratin Treatment service.

- Allow your hair to heal through Hair Treatments, Time and/or Trims.
- Reduce or stop the use of ALL heating tools 3-4 weeks before your Keratin Treatment service.
- Hair that is already damaged (brittle, dry, shedding or breaking) should not be treated with Keratin until the clients’ hair is treated with a series of Hair Rebuilding Treatments
- HIGHLY RECOMMENED - Bring your hair back to life with our Damaged Hair Rebuilding Treatment.

Our In- Salon Damaged Hair Rebuilding Treatment gives substance and strength to damaged hair and supplies the hair with its essential missing nutrients. 3-5 sessions recommended.

Damaged Hair Rebuilding Treatment $120 per session

Our Damaged Hair Repair Kit is available for purchase for at home use
PRODUCT USAGE

Starting Treatment prices are for chin length hair of average density. Price increases based on length and density.

EXTRA BOWL(S) OF KERATIN

SHORTER HAIR LENGTHS - .5 OZ OF Keratin Solution Included - Extra Keratin is charged $50 per .5 OZ

MED - LONG HAIR LENGTHS - 2 OZ OF Keratin Solution Included - Extra Keratin is charged $50 per .5 OZ

The base price for the smoothing treatment is based on the manufacturer's recommended amount of product. Most clients will not need extra product
HAIR SMOOTHING (KERATIN) RETOUCH
A Re-touch Application is recommended Every 3-4 months

A Trim Regimen of 10-12 weeks is also highly recommended to reduce shedding and split ends

TREATMENT + DATE mm/dd/yyyy
TREATMENT + DATE mm/dd/yyyy
TREATMENT + DATE mm/dd/yyyy
TREATMENT + DATE mm/dd/yyyy
TREATMENT + DATE mm/dd/yyyy

Hair Smoothing (Keratin) Treatment Release Form

In order to ensure a quality service, please read, initial and sign and date the following statements. *

I acknowledge that this is a virtual hair analysis and consultation with a Keratin Certified Hair Stylist.
I have provided all information regarding previous treatments to my hair and/ or color that may or may not affect the outcome of my service.
I understand Failure to provide true or accurate information can result in possible damage to my hair as well as lack of treatment consistency or effectiveness.
I understand that My stylist will explain to me the process they recommend for my hair type, texture, condition and desired results.
I understand that Keratin Treatments are designed to minimize frizz while enhancing the appearance of the natural wave/curl.
I understand that I will be given aftercare instructions and product recommendations to best care for, preserve and prolong my Keratin treatment results.
I understand that a Keratin Treatment is not a chemical relaxer or chemical straightener, and that Endless Creations Salon, and any affiliates do not guarantee straight hair by performing this service.
I am not pregnant or nursing, and I have advised my stylist of any potential concerning medical conditions including asthma or respiratory disease.
I release my stylist, Endless Creations Salon and any affiliates from any liability during or after my Keratin treatment.
I agree to all aftercare instructions and understand that my Keratin service is non-refundable and non-negotiable
In order to book my Keratin treatment, I agree to pay a non-refundable retainer of Specialty Service deposit to secure my appointment slot.

Date Time *
MM / DD / YYYY
Signature *
Clear

PERSONAL INFORMATION

CLIENT STATUS

HAIR TEXTURE - TYPES - DIFFERENCES

CURRENT HAIR CONDITION

CURRENT SCALP HEALTH

CURRENT HEALTH

HAIR DENSITY

HAIR SMOOTHING (KERATIN) TREATMENT & ANTI-FRIZZ PRICING

HAIRSMOOTHING (KERATIN) GOAL

HAIR HISTORY

HAIRSMOOTHING (KERATIN) GOALS

YOUR AVAILABILITY

HAIR SMOOTHING (KERATIN) TREATMENT SCHEDULING

HAIR SMOOTHING (KERATIN) TREATMENT RESCHEDULING

HAIR SMOOTHING (KERATIN) TREATMENT CONVIENCE APPOINTMENT SLOTS

FLEXIBLE PAYMENT OPTIONS

CONSULTATION PURPOSE

HAIR SMOOTHING (KERATIN) TREATMENT DEPOSIT

HAIR SMOOTHING (KERATIN) TREATMENT FINAL PAYMENT

HAIR SMOOTHING (KERATIN) TREATMENT CANCELLATION NOTICE

HAIR SMOOTHING (KERATIN) TREATMENT LATE ARRIVAL

HAIR SMOOTHING (KERATIN) TREATMENT PREP:

HAIR SMOOTHING (KERATIN) TREATMENT RECOMMENDATIONS FOR DAMAGED HAIR CLIENTS

PRODUCT USAGE

HAIR SMOOTHING (KERATIN) RETOUCH