Clients

Does your loved one live at a facility we manage?

Let's Get Started!
We encourage all clients, family members, and responsible parties to complete the form below. Be as detailed as possible of the needs and expectations of the guest so we can better serve you. Pricing may vary depending on each individual facility.

A woman sitting in a chair with her hair cut.

Become A Customer Of Our Communities

Thank you for choosing Hair We Go as your salon service provider. Complete Form Below.
Residents First and Last Name(Required)
MM slash DD slash YYYY
Billing Address(Required)
Is resident able to request additional salon services?
Styling Services
Chemical Services
Nail Services
Shaping Services
Waxing Services
Facial Services
(Please Note There is an addition $20 Fee added for in room services)
Appointment Reminder
Would you like to receive text messages or email reminders about upcoming appointments?

Provide the name of each service you are requesting beneath the appropriate frequency of appointments. Please note that stylists are typically available 1-2 days a week. If you're unsure of how often services should be provided, consultations are available. Clients who request services on a walk-in basis should specify that in the “Special Request” section below
MM slash DD slash YYYY
Weekly Services
1.
2.
3.
 
Monthly Services
1.
2.
3.
 

Credit Card Authorization Form

Hair We Go will process payments within 3-5 days of services. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until canceled.

Card Type(Required)

Your signature gives submission to Hair We Go to provide salon services and your agreement to pay all service fees on a timely basis. Payment will be made by debit/credit card.

I, ________________, authorize Hair We Go to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.

This field is for validation purposes and should be left unchanged.

"A kind gesture can reach a wound that only compassion can heal." - Steve Maraboli