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21
Questions
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1
Client's Name
First Name
Last Name
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2
Date of Birth
-
Date
Month
Day
Year
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3
Client's Phone Number
Area Code
Phone Number
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4
Client's Email Address
example@example.com
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5
Drop a picture of your desired look or inspiration
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
You can upload multiple files here
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6
Drop an image of your current hair/face
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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You can upload multiple files here
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7
Service needed
You can select multiple if you need more than one service!
Color/blonding services
Haircut
Special occasion makeup
Special occasion hair
Halocouture color match
Blowout
Conditioning treatment
Consultation
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8
Times/days of availability
Desired appointment date
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9
Tell me a little more about what service you are wanting done, and previous hair history.
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10
Preferred maintenance schedule?
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
Other
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11
How long is your hair?
Short
Medium
Long
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12
What is the condition of your scalp?
Dry
Normal
Oily
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13
How often do you apply shampoo and conditioner in your hair?
Every day
Every other day
Twice a week
Once a week
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14
When did you last apply professional or unprofessional color in your hair?
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15
Kindly list the hair products that you are using
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16
What are the tools you are using to style your hair?
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17
How did you hear about us?
Facebook
Twitter
Instagram
YouTube
Online Advertisement
Google Search
Referred by a friend
Newspaper/Magazine
Other
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18
Terms and Conditions
*
This field is required.
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19
By signing below, I agree to the terms and conditions of the salon company.
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20
Client's Signature
Clear
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21
Date Signed
-
Date
Month
Day
Year
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