Hair Consultation - Hair Assessment Form
Select an appointment
Client's Phone Number
Client's Email Address
Tell us the reason for this consultation?
How often do you go to salon for hair treatment?
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
How long is your hair?
Short - Bold or shaved or small afro
Medium - Ear length to shoulder
Long - Past shoulder
Kindly describe the status of your scalp.
How often do you apply shampoo and conditioner in your hair?
Every other day
Twice a week
Once a week
What is the current condition of your hair?
Damage due to heat
Hair is dry
Have you used the following in your hair before?
Permanent hair color
When did you last visit a hair salon?
When did you last apply professional or unprofessional color to your hair?
Have you have any hair loss problems in the past?
Are you currently taking any medications? If yes, please list them below.
Please indicate the hair products you are currently using:
How did you hear about us?
Referred by a friend
Any special instructions, comments, or suggestions?
( X )
Hair consultation - Hair assessment
-Assessment of your hair type, texture, and condition -Assessment of your overall health -Determining your top hair concerns and goals -Establishing a basic hair care regimen and product recommendations (written resources provided)
Credit Card Number
Should be Empty: