Questionnaire Form
Divinity Ray Hairstylist
Name
First Name
Last Name
Email
example@example.com
Zip Code
Phone Number
-
Area Code
Phone Number
Birthday
-
Month
-
Day
Year
Date
Zodiac
Aries
Taurus
Gemini
Cancer
Leo
Virgo
Libra
Scorpio
Sagittarius
Capricorn
Aquarius
Pisces
Instagram
What hair services are you interest in?
Undercut Cut
Fade Cut
Pixie Cut
Medium Cut
Long Cut
All Over Color
Cut + Color
Bleach + Tone
Bleach + Tone + Cut
Partial HL
Partial HL + Cut
Full Foil HL
Full Foil HL + Cut
Balayage
Balayage + Cut
Multi-Dim
Multi-Dim + Cut
Vivid (SP)
Vivid (SC) + Cut
Vivid (DP)
Vivid (DP) + Cut
Rainbow Hair
Rainbow Fair + Cut
How would you describe your hair type?
Fine
Medium
Thick
Very Thick
How would you describe your hair texture?
Straight
Wavy
Curly
Very Curly
What's your current hair color?
White
Blonde
Strawberry Blonde
Ashe Blonde
Light Brown
Medium Brown
Dark Brown
Black
Red
Highlighted
Balayage
Vidid
Rainbow Hair
What's your current length?
Fade
Short
Medium
Long
Have you colored your hair professionally before?
Yes
No
If yes, when?
Have you ever used box dye?
Yes
No
If yes, when?
Have you chemically straightened or permed your hair?
Yes
No
Do you have a sensitive scalp?
Yes
No
Do you have any known allergies?
Yes
No
If yes, what are they?Type a question
Are you currently pregnant?
Yes
No
Have you ever suffered from hair loss?
Yes
No
Have you ever been diagnosed with Alopecia?
Yes
No
If yes, what are they?
Do you frequently swim or go to the gym?
Yes
No
Have you ever experienced scalp burn? If so, please explain:
Do you have any medical needs I should know about?
How often do you get your hair done?
Describe your current hairstyle and the hairstyle you are desiring:
Are you currently going through anything in your life inspiring the change?
Do you suffer from depression, anxiety, or anything mental health related you'd like me to be aware of?
Are you willing to travel to New York? If not, where are you located?
Please share anything else that may be important pertaining to your service:
How did you hear about me?
Friend
Family
Co-Worker
Instagram
Facebook
TikTok
Youtube
Google
Submit
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