FRONT DESK ONLY: Name of person submitting this form: *

First Name

Last Name

Guest Name *

First Name

Last Name

Guest Original Service Date *

MM

DD

YYYY

Original Service Provider *

First Name

Last Name

Services Booked at original appointment: (check all that apply) *

Hair Cut

Blow Out / Style

Color (Roots or All Over)

Highlights

Treatment

Waxing

Tinting (Brow &/or Lash)

Brow Laminating

Lash Lift

PMU

Services Guest is unhappy with *

Hair Cut

Blow Out / Style

Color

Highlights

Treatment

Waxing

Tinting (Brow &/or Lash)

Brow Laminating

Lash Lifting

PMU

Was the guest willing to see the same stylist? *

Yes

No, due to scheduling reasons

No, due to guest being unwilling

Redo scheduled with:

First Name

Last Name

Date of redo service:

MM

DD

YYYY