New Client Consultation Form

1
Today's Date* This field is required.
Date
Month
Day
Year
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.
4
Phone Number* This field is required.
5
When was the last time you colored your hair?* This field is required.
6
What type of color was used on your hair last?* This field is required.
Box Dye
Professional Permanent Color
Professional Demi Color
Henna Hair Color
None/Virgin Hair
7
Has henna color dye ever been used on your hair?* This field is required.
Yes
No
8
How would you describe your hair?Select all that apply.
Thick
Normal
Thin
Fine
Medium
Coarse
Brittle
Dry
Healthy
Frizzy
Curly
Wavy
Straight
Flat
9
Have you ever needed to book extra time for your hair appointments?* This field is required.
Yes
No
10
Describe your hair goal.* This field is required.
11
With reference to time, how quickly do you expect a stylist to achieve your desired ideal hair look? (i.e. with one session, within several months, etc)* This field is required.
12
Please upload inspiration photos here* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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13
Please upload three current hair photos of the following: (1) a top-down view of your hairline, (2) a side profile photo (3) a photo of the back of your head with your horizontal part so we can see your roots.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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14
Which Clementine's location are you interested in?* This field is required.
Arvada
Denver (LoHi Neighborhood)
Aurora (Stanley Marketplace)
Any salon
15
How did you hear about Clementine's Salon?* This field is required.
Website / Online Search
Yelp
Facebook
Referral
Instagram
Other
16
If Referral, please list name
17
What brand(s) of Shampoo + Conditioner to you currently use?
18
Any known allergies?* This field is required.
Tree Nuts
Fragrances / Essential Oils
Other
None
19
Leave us a note with anything else you would like us to know.
20
Reservation & Cancellation Policy for all current and future appointments: a valid credit card is required for all appointments. Please do not forget to confirm your appointment when you receive your reminder from Clementine's Salon. In the event of cancellations received less than 24 hours prior to appointment, a cancellation fee equal to 50% of the reserved service booked will incur. No Shows will be charged 100%* This field is required.
I understand the reservation and cancellation policies at Clementine's Salon and consent to my credit card on file being charged if I fail to give 24 hour notice for appointments.
21
Signature* This field is required.
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