Hair Color Consultation Form
Full Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthday
Are you new or existing clients?
New
Existing
Existing (last appointment more than 1 year)
What color service are you interested in receiving?
Gray coverage, Root color retouch
Single color service
Highlights
Highlight & Base
Baby lights
Balayage/foilyage
Gloss/glaze
Color Correction
Bleach & tone
Color makeover
Transition to natural grey
Daily availability
Tuesday
Wednesday
Thursday
Friday
Saturday
Time availability
Morning
Afternoon
Late afternoon
Time Frame availability
1-3 hours
3-5 hours
6-8 hours
Other
What is your Budget for your color
$80-$200
$200-$400
$400+
Other
Preferred Stylist
Desired service
Please attache a clear picture of your current hair in natural light, no filters. (front view)
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Please attache a clear picture of your current hair in natural light, no filters. (side view)
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Please attache a picture of your current hair in natural light, no filters(back view)
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Please attache a photo of your hair inspiration/desired goal.
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Type of Hair texture
Straight
Wavy
Curly
Tighter curls
Type of Hairdensity
Fine
Medium
Thick
Super thick
Current length of Hair
Extra short (1 inch or less)
Short (above ear)
Medium (above shoulders)
Long (Below Shoulder)
Extra Long (lower back)
Hair Condition
Normal
Dry
Oily
Damamged
Split ends
Other
Scalp condition
Flaky
Dry
Itchy
Oily
Other
Where did you hear about this salon?
Facebook
Instagram
YouTube
Internet search
Google Search
Referred by a friend
Newspaper/Magazine
Yelp
Yelp
Other
How often do you visit a salon?
Please Select
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
Hardly ever
When was the last time you colored your hair?
Less than 1 month ago
1-3 moths
3-6 months
Over 6 months
When was the last cut/trim?
Less than 3 moths ago
less than 6 months ago
less than 1 year ago
More than 1 year ago
For hair color, what maintenance schedule do you prefer?
Every 4-6 weeks
every 6-8 weeks
every 3-4 months
Twice per year
Once per year
No maintenance; this will be a one-time color service
How much grey do you have?
A lot! (75-100%)
A good amount! (50-75%)
Hardly any (10-25%)
None (0%)
How often do you straighten, flat-iron or use hot tools on your hair?
Never
A few times per year
Every few weeks
Every week
Every day
What chemicals have you used in the last 3 years?
None
Hair Color (salon)
Hair Color (at home)
semi permanent/rinse
relaxer/perm
keratin / Brazilian Blowout
other
Do you wear extensions?
Yes
No
Please share your hair color history?
Please give us a brief 3 year color history. Have you ever colored your hair with Henna or boxed color (hair black or red)? when was it last applied? if never type "never"
Please tell us about your regimen. What do you use for cleansing, styling, conditioning, and how do you style your hair?
Are you using any hair products? If yes, please list them below:
Are you currently taking any medication that has side effects that can cause hair thinning and/or hairloss, or may alter hair color results?
Yes
No
Are you pregnant?
Yes
No
Any special instructions?
Date Signed
-
Month
-
Day
Year
Date
Client's Signature
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