Client Consultation Form

Client Consultation Form

Please fill out this form to proceed with the booking process.
Name *

First Name Last Name
Phone Number *
Email *
example@example.com
Select a salon service

Hair Color Cut/ Shape Highlights Nail Care Make-up Iron/Curling Shampoo & Blowdry Straightening and Perming Waxing Treatments Other
Upload an image of the current hair

You can upload multiple files here
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Upload an image of the hair style you prefer/desire

You can upload multiple files here
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Any special instructions?
How often do you go to salon?

Every week Every 2 weeks Every 3-4 weeks Every 2 months Every 2-6 months Twice a year Once a year Other
How long is your hair?

Short Medium Long Over 12" In Length
How often do you apply shampoo in your hair?

Every day Every other day Twice a week Once a week Other
Kindly describe the status of your scalp.

Dry Normal Oily Other
Describe your hair by checking the options below: (You can select more than one)

Healthy Damaged Straight Wavy Curly Fine Thick Other
When did you last apply professional or unprofessional color in your hair?
Do you have any hair loss problems in the past?
Are you currently taking any medications? If yes, please list them below. If not, please put N/A.
Please indicate the list of hair products you're currently using:
How did you hear about this salon?

Facebook Twitter Instagram YouTube Online Advertisement Google Search Referred by a friend Newspaper/Magazine Other
Client Signature

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Date Signed

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Date
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