New Client Intake Form

Name: *

Type a question

Telephone: *

Date of Birth:

Email: *

How did you hear about us? Facebook, Instagram, or did someone refer you? *

Are you 100% Natural? *

When was your last relaxer?

Are you allergic to anything? If so, please list them: *

Are you taking any medications such as thyroid or high blood pressure medication?

What made you decide to go natural?

Please name some of the products that you use?

Do you have any hair loss, breakage, or thinning? *

Do you have any scalp tenderness, itching, flacking, or dryness? *

Are you under the care of a dermatologist?

Have you worn tight braids, sew in weaves, bonded weaves, or lace front wigs recently?

What are your hair goals?

What are your expectations for this visit?

We photograph and record our work throughout the salon for promotional, public relations activities, and social media. We typically do not use names only photos and videos. All photographs and recordings are property of Taji Natural Hair Styling.

I consent to being photographed. I do not consent to being photographed Type option 3

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Date

I understand that I should have removed my previous style, completely detangled and combed through my hair. This helps my stylist stay on schedule. If my hair needs more detangling than a normal 15 minute shampoo will allow, a detangling fee may be applied. If my stylists schedule doesn’t allow for the additional time needed, my appointment may need to be modified or rescheduled. I will let my stylist/salon assistant know of any special care that my hair may need when I arrive for my appointment.

**It is my choice to receive natural hair care services. I have completed this form to the best of my knowledge. I have stated all medical conditions that I am aware of and I will update Taji Salon of any changes to my health status. I understand that Natural Hair Care Practitioners do not diagnose illness, disease, or physical disorders, nor do they prescribe medical treatments, or pharmaceuticals. If I am unable to make a scheduled appointment, I agree to cancel the appointment 24/48 hours in advance by phone. If I miss a scheduled appointment without giving a 24/48 hour notice, I agree that my credit card can be charged for the missed appointment fee that applies. Specialty services such as extensions or services that exceed 3 hours will require a 48 hour cancellation window and a non refundable deposit. I agree that I have consented to have my hair styled regardless of the stylist expressing concerns for the health of my hair and scalp.

**If you are not satisfied with your style in any way let your stylist know before you leave. We will do our best to rectify the situation at that time or will remove the style for you. After this time you will not be eligible for a style re-do or any sort of refund. If you are not satisfied with your service in any way, please let us know within the time of your visit. We are not responsible for missing or damaged property while in the salon. Please keep your belongings with you.

Please sign: