New Client Consultation Form

Client Questionnaire

Let me get to know your hair before we meet
Name*

First NameLast Name
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number *

Area CodePhone Number
Email*
example@example.com
How did you hear about Hair by Maranda?*

Website / Online SearchYelpFacebookReferralOther
If Referral, please list name
What is your reason for looking for your new salon home?*
Your Hair Profile
What are your hair care goals? *
Which best describes your hair type?*

Fine and thinFine but lots of itNormal, average densityCoarse and thinCoarse and thick
What are your hair care challenges?*

No VolumeToo thickDrynessBreakageFrizzinessWon't stay curledDullCurly hair & don't know what to do with it!Other
What are you trying to achieve with your style?*

VolumeCurlStraightOther
Average visits to a salon:*

every 6-8 weeksEvery 3-6 monthsEvery 6-9 monthsOnce a year
What is your typical daily styling routine?*
How much styling time is spent at home?*

Less than 15 min.15-30 min.30-45 min.More than 45 min.
What is your home styling comfort level?*

UncomfortableComfortableVery ComfortableI Want some Tips
What kind of styling tools are you using at home during your hair routine?*

Flat IronCurling IronBlowdryerStyling tool? Ain't nobody got time for that!Other
Hair Versatility*

Wear my hair the same everydaySometimes wear my hair differently on weekendsOpen to new styles & change oftenTry a new look everyday
Have you ever had a hair conditioning treatment service before?*

YesNo
What hair care products do you currently use?*
What do you wish your hair did more of?
Hair History

We have all done crazy things with our hair! Sometimes our daily routine will effect the outcome of your hair service. We just want to make sure your service will have the best results. So please be truthful and honest with the following questions. We don't judge.
Are you currently taking any prescriptions, vitamins, or hormones? If yes please list the items that may effect your service today.*

NoYesOther
Have you ever experienced hair loss or scalp problems?*

NoYesOther
Do you presently have any breakage?*

NoYes, bleach damageYes, styling damageYes, my hair just is fragile and breaks easilyNot sure
Please select any of the following chemical hair services you’ve received either professionally or at home.
Used Henna, a natural form of hair coloring

Nope neverYes but its been yearsYes currently coloring with Henna
Used box color (at home color remedy) This is VERY important to be honest!
If you have used box color, what was the goal?*

Staying my natural color but covering gray hairWent darker then my natural colorHaving fun with Red shades (not my natural color)Only professional color for me!
What color is your natural hair color?*

Light BlondeDark Blondestrawberry BlondeRed/AuburnLight BrownDark BrownAlmost Black
Do you have any gray hair ?*

yes, very noticeable and I want it covered!yes, some but I like it highlighted to blend in (no base color)Just a few, I pluck them out or embrace themNope, not yet
Have you had any blonding (highlights or balayage) services done?*

Yes, I LOVE being as blonde as I can beYes, I have highlights but still like dimensionyes, in the past but don't currently have anyNo, never tried them
If you have previously done some form of blonding which best describes your hair?*

Wanted to try something new and colored over them (professionally)They have grown out, now only have them at the ends and am wanting a blonde refreshThey have grown out and have been cut off
Have you ever received a chemical straighter or relaxer service or treatment?*

Yes, within the last monthYes, within the last 6-12 monthsNo
Please feel free to go into more detail about any questions you may have for your stylist
I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the hair service being received.*

Yes
Signature*

Clear
Please take a couple hair selfies!*
Upload some desired Hair results*
What about this picture do you like?*
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Client Questionnaire

Your Hair Profile

Hair History

Please select any of the following chemical hair services you’ve received either professionally or at home.