First Name: Last Name:

Appointment Date:

Was this your first visit to Via Salon? Yes No

Was the front desk staff polite, knowledgeable and prompt during your call? Yes Somewhat No

Were you greeted promptly? Yes No

What service did you receive?
Hair Cut or Style Hair Coloring Make-Up Bridal   Manicure Pedicure

Please specify services rendered and Stylist and/or Spa Technician:

Were the salon staff members friendly and helpful during your visit?
Yes Somewhat No

Did the salon appear clean and neat during your visit?
Excellent Good Fair Poor

Did your stylist educate you on the products used during your visit?
Yes Somewhat No

What would you rate your Stylist and/or Spa Technician?
Excellent Good Fair Poor

How would you rate your overall salon experience with us?
Excellent Good Fair Poor

Please feel free to list any additional information, or elaborate further on any of the above questions.

We truly appreciate your honest feedback. We are always striving for ways to help improve our guests experience. Feel free to contact us at any time with any questions or concerns you may have.