Form
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Birthday
-
Month
-
Day
Year
Date
Tell me about the condition of your hair
Healthy
Oily
Dry
Damage
Your hair feels (check all that apply)
Thick
Thin
Normal
Coarse
Fine
Curly
Wavy
Flat
Oily
Dry
Dull
Short
Medium
Long
Extra long
When was the last time you colored your hair?
2-4 weeks
1-2 months
Longer than 4 months
Never color my hair
Was the color done by a professional hairstylist?
Yes
No
Can't remember
Never color my hair
Have you used box color in the past 3 years?
Yes
No
N/A
Has your hair being previously permed, chemically straightened or relaxed?
Yes
No
What do you currently love about your hair?
What do you currently not like about your hair?
Please describe the best color and style you have ever had
Have you ever had an allergy reaction to any hair products?
Yes, every time I color my hair
Yes, once in awhile
No
I can't remember
Let's talk about maintenance schedule. How often can you commit to visit the studio in order to keep your hair looking marvelous?
4-6 weeks
6-8 weeks
8-12 weeks
4-6 months
Do you have scalp issues?
Yes
No
Sometimes
If Yes, Please describe...
How long are you willing to spend in my chair every visit?
1 hour
2 hours
3 hours
Whatever it takes!
How much are you willing to invest in your hair every visit?
$100
$200
$300
Whatever it takes!
How much are you willing to invest in at home care products at this visit?
$25
$50
$100
Whatever it takes!
When it comes to your end result, Which of the following statements is how you feel about your visit?
Get to my hair goal as quickly as possible even if it means I might have to get a significant haircut
Keep my hair as healthy as possible even if it means my dream color will take a few appointments to get there
I want a full makeover and I can spend as much money as needed to get me there
How long do you spend styling your hair every morning?
15 minutes
30 minutes
45 minutes
I just shampoo and go
Your hair color goals are:
Blonde inspired
Blonde, blonde, blonde!
Darker than my natural
Gray coverage
Red all the way
Fashion colors
I change my mind every time I visit the salon
Is there anything else you would like to add ?
Submit
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