EmailMe Form - ECS: KERATIN /ANTI-FRIZZ CONSULT FORM

ECS: KERATIN /ANTI-FRIZZ CONSULT FORM

NOTE: Hair Smoothing (Keratin) Treatment services are currently available Tuesdays - 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, reduce bulk, add shine and make your hair more manageable.

The Hair Smoothing (Keratin) treatment process takes approximately 2 - 3.5 hours depending on the client's hair length, density, texture and requested Keratin system. Please be mindful of this when scheduling.

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HAIR SMOOTHING (KERATIN) TREAMENT ONLINE CONSULT FORM is complimentary.

HAIR SMOOTHING (KERATIN) IN-PERSON CONSULT 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 CONSULT FEE MUST BE SUBMITTED UPON COMPLETION OF THIS FORM.

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 appointmentdesk@endlesscreationssalon.com

TEXT US at 480-485-4413

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 (Keratin) 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
Gender Identity of the person receiving services *
Male
Female
NON-BINARY
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
I am a *
New Client (1st Visit)
Welcome Back Client (4+ 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
I am scheduling a Hair Smoothing (Keratin) Treatment for: *
Myself
My Child
My Grandchild
Friend
Other
Name of the person receiving a Keratin Treatment: *
First Last
How often do you go to a salon for hair services? *
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Once a year
Twice a year
When was your Last professional salon visit? And, what service(s) did you receive? *
Type N/A if this does not apply to you
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.
What is your hair type? *
Fine
Straight
Wavy
Curly
Coily
Kinky
Kinky-Curly
Combination, please list
Please select the option that best describes your hair texture
What is your hair texture? *
Fine
Medium
Coarse
Please select the option that best describes your hair texture

FINE: Fine strands appear to be thin and may not hold styles well.

MEDIUM: Medium strands appear full and hold styles well.

COARSE: Coarse strands are very full and hold styles well.
What is your degree of curl?: *
Slight to Minimal Wave
Open Loose Wave
Very Wavy
Curly
Loose Curls
Very Curly
Spiral Curls
Corkscrew Curls
Coily
Very Coily
Z-Coils
Tight Coils
Please select the option that best describes your hair texture
CURRENT HAIR CONDITION
Please be honest. Our goal is to address your hair care issues and suggest appropriate remedies
CONDITION: What is the current condition of your hair? *
Damaged Strands
Unmanageable hair
Transitioning hair
Limp curls
Dry Hair
Frizzy
Breaking Off
Shedding
Falling Out
Split Ends
Hair Style needs Shaping
Other
Does your hair become knotted or tangled? *
Yes, Sometimes
All the time
No, not at all
Not often
If yes, please explain
Do you feel like your hair is shedding/thinner 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
LENGTH: How long is your hair?
Please check the hair length that most accurately describes the length of your hair. *
XXSHORT | ABOVE CHIN/NAPE
XSHORT | BETWEEN NAPE & MID NECK
SHORT | TOUCHING SHOULDER & ABOVE
MED LONG | BELOW SHOULDER
LONG | TOUCHING SHOULDER BLADE
XLONG | BELOW SHOULDER BLADE
XXLONG | TOUCHING BRA-LINE
XXXLONG | BELOW BRA-LINE TO 2 INCHES BELOW
XXXXLONG | 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.
SHAMPOO: How often do you shampoo your hair? *
Every day
Once a week
Every other week
2-3 times per week
Once per month
Other
CONDITION: 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 *
Type N/A if this does not apply to you
How often do you have hair Treatment(s)? And, when was your last treatment? *
Deep Conditioners, Proteins and Masque Treatments.

Type N/A if this does not apply to you
Explain your hair care and conditioning regimen? *
Do you generally get.... *
Professional Hair Care by a Licensed Stylist
Do-it-youself
Go to a Braider/Weave
Go to an Unlicensed Stylist/Friend/Relative
HAIRLINE: Is your hairline... *
Healthy
Thinning
Bald on Both sides
Bald on One side
If Bald, please explain
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 3 inches
Circumference of up to 3+ 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 11 inches
Circumference of 12-14 inches
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.
HAIRCUTS AND TRIMS
How often do you receive a HAIRCUT? *
Every 3-4 weeks
Every 4-5 weeks
Every 6-8 weeks
Every 8-10 weeks
Every 10- 12 weeks
Other
A HAIRCUT is changing shape of your hair completely.
How often do you TRIM you ends? *
Every 3-4 weeks
Every 4-6 weeks
Every 6-8 weeks
Every 8-10 weeks
Every 10- 12 weeks
Other
A HAIR TRIM maintains the style and shape of a HAIRCUT as well as removes split ends
When was your Last professional trim by a Licensed Hair Stylist? *
If you HAIRCUT/TRIM AT HOME, when was your last haircut/trim? *
Type N/A if this does NOT apply to you
What is your ideal Hair Cut length? *
CHEMICALS
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.
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.
Do you currently have ANY COLOR that has been applied to your hair within the past 2 years? If so, please describe what and when for each *
(i.e. Box Color, professional color, rinses, glosses, henna, highlights, lowlights, henna, etc.
Do you currently have ANY CHEMICAL(s) that has been applied to your hair within the past 2 years? If so, please describe what and when for each *
RELAXER, TEXTURIZER, CURLY PERM, PERMANENT COLOR, DEMI-PERMANENT COLOR, HIGHLIGHTS, BLONDING, BALAYAGE ETC.

TYPE N/A IF NOT APPLICABLE
Have you ever had problems with chemical services? *
(i.e. breakage, sensitivity, resistant areas, etc.)
Is there any over-the-counter chemical product currently on your hair? If yes, please explain *
HEAT & YOUR HAIR
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, my hair is damaged due to heat
No, my texture is intact
I’m unsure
Other
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
KERATIN HISTORY
Have you ever had a Keratin Treatment service on your hair? Yes or No? If yes When? Where? What brands? How long ago? And, what was the RESULTS *
If no, type N/A
KERATIN GOALS
What is your desired Finishing Keratin result? *
Improve manageability
Reduce Frizz
Decrease Blow Dry Time
Smooth Texture
Soften Curl Pattern
Enhance Curl Definition - IRewant to keep my curls, but reduce volume
Reduce Volume
Versatility between Straight & Curly Styles
Hair Growth
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.
How committed are you to the Maintenance of your Keratin Treated hair service *
If no, type N/A
Describe as thoroughly as possible in your own words your desired Keratin results. *
WHAT IS YOUR LONG-TERM KERATIN GOAL?
Would you like to add-on other services to your Hair smoothing (Keratin) Treatment service? *
Olaplex, Trim, HairCut, Semi or Demi Color, etc.
CURRENT SCALP HEALTH
Is your scalp itchy or flaky? *
Yes, Itchy
Yes, Flaky
Yes, Itchy and Flaky
No
I am not sure
Do you have any hair loss problems now or in the past? *
Is hair loss a genetic issue in your family?
CURRENT HEALTH
Have you taken any type of medication in the past six (6) months? If yes, please list *
Have you gone through menopause or could be pre-menopausal? *
Yes
No
Are you currently pregnant or have given birth in the past year? *
Yes
No
Have you had any surgery that required general anesthesia in the past year? *
Yes
No
Please list any known allergies *
List all current Medications. If no medication, type N/A *
HAIR SMOOTHING (KERATIN) TREATMENT & ANTI-FRIZZ PRICING

Final Price depends on length and density
KERATIN SMOOTHING TREATMENT PRICING OPTIONS:

FOR STRAIGHT, RELAXED & WAVY HAIR TEXTURES

SPECIALTY SERVICE DEPOSIT REQUIRED FOR BOOKING - TEXT US @ 480-485-4413 FOR SPECIALTY DEPOSIT LINK *
BRAZILIAN BLOW OUT | ADULT [$175 - $375] LAST UP TO 3 MONTHS
BRAZILIAN BLOWOUT | TWEEN [$150 - $350] LAST UP TO 3 MONTHS
KERATIN COMPLEX EBO - EXPRESS BLOW OUT | ALL [$75 - $120] LAST UP TO 6 WKS
KERATIN COMPLEX KCMAX | [$200-$430+] LAST UP TO 3 MONTHS
KERATIN COMPLEX PBO | ADULT [$175 -$395] LAST UP TO 3 MONTHS
KERATIN COMPLEX PBO | TWEEN (ages 6-12) [$150 -$325] LAST UP TO 3 MONTHS
PLEASE SELECT THE REQUESTED KERATIN TREATMENT.

PRICE RANGES ARE LISTED. VISIT OUR ONLINE BOOKING SITE FOR DETAILED PRICING AND SERVICE 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.
TEXTURED KERATIN TREATMENT PRICING OPTIONS:

FOR CURLY, KINKY COILY HAIR TEXTURES

SPECIALTY SERVICE DEPOSIT REQUIRED FOR BOOKING - $85 Link listed below. *
DE STS - KERATIN TREATMENT | ADULT [$120 - $250]
DE STS KERATIN TREATMENT LAST UP TO 3 MONTHS| TWEEN AGES 6-12 YRS [$110 - $230]
KCTEXTURE CURLY KERATIN [250]
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 PRICING AND SERVICE 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.
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
YOUR AVAILABILITY
How soon would you like your Hair Smoothing (Keratin) service? *
ASAP - TODAY WOULD BE GREAT
IF SOMEONE CANCELS, CALL ME
SOMETIME THIS MONTH
SOON - WITHIN THE NEXT WEEK
WHAT ARE THE BEST DAYS FOR AN APOINTMENT *
WHAT DAY(S) AND TIME OF DAY DO YOU PREFER? *
DAY | MM/DD/YYYY
TIME | HH | MM | AM/PM
SCHEDULING YOUR KERATIN) TREATMENT
Appointments for a Hair Smoothing (Keratin) services are currently available on Tuesdays - Saturdays.

CONVENIENCE FEES
If you would like to schedule a Keratin Treatment 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.
HAIRSMOOTHING (KERATIN) TREATMENT COMMENT BOX *
Anything else you want us to know

We reply to you VIA EMAIL within 1-3 business days. and will 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 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
Payment Plan Option 4 easy payments
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 PLAN Link.
CONSULTATION PURPOSE
The purpose of this Consultation is to make your Keratin Treatment service 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 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.
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

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

DENSITY

HAIRCUTS AND TRIMS

CHEMICALS

HEAT & YOUR HAIR

KERATIN HISTORY

KERATIN GOALS

CURRENT SCALP HEALTH

CURRENT HEALTH

HAIR SMOOTHING (KERATIN) TREATMENT & ANTI-FRIZZ PRICING

YOUR AVAILABILITY

SCHEDULING YOUR KERATIN) TREATMENT

FLEXIBLE PAYMENT OPTIONS

CONSULTATION PURPOSE

HAIR SMOOTHING (KERATIN) TREATMENT DEPOSIT

HAIR SMOOTHING (KERATIN) TREATMENT FINAL PAYMENT

PRODUCT USAGE

HAIR SMOOTHING (KERATIN) RETOUCH