Client Consultation Form
Welcome, I can’t wait to meet you!
Name
*
First Name
Last Name
Date of Birth (For a fun gift every year)
*
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Method of Contact
*
Phone
Text
Email
How did you hear about Leandra Renz Hair ?
*
Referral
Website
Instagram
Google
Facebook
Other
If Referral, please list name
If Other, please let me know
Available Days
*
Tuesday Morning
Wednesday Morning
Thursday Morning
Thursday 4 o’clock
Saturday (waitlist)
Your Hair Profile
What Service are you looking to get ?
*
Haircut
Balayage
Fashion Color
Corrective Color/Transformation
Solid Color
Gloss/Root Touch-Up
No idea what to book
What are your hair care goals?
*
Average visits to a salon:
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every 4-6 weeks
Every 6-12 weeks
Every 3-6 months
Once a year
How much does budget affect you your hair choices?
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I will choose an option based on my budget
I am willing to compromise based on what I want and upkeep
While I am price conscious, my vision for my hair won’t change based on price
My hair is an investment, not a concern for me
What are your morning hair rituals?
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How much styling time is spent at home?
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Less than 15 min.
15-30 min.
30-45 min.
More than 45 min.
What kind of styling tools are you using at home during your hair routine?
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Flat Iron
Curling Iron
Blowdryer
Styling tools?
Other
Hair
*
Wear my hair the same everyday
Sometimes wear my hair differently on weekends
Open to new styles & change often
Try a new look everyday
What hair care products do you currently use?
*
Are you open to changing your hair care routine? With products designed to help keep the longevity of color?
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Yes
No
Not Sure
Hair History
We have all done crazy things with our hair! Sometimes our daily routine will effect the outcome of your hair service. I just want to make sure your service will have the best results. So please be truthful and honest with the following questions. There is no judgement, I just want the best for you and your hair!
Are you currently taking any prescriptions, vitamins, or hormones? If yes please list the items that may effect your service today.
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No
Yes
Other
List of vitamins, prescription or hormones.
*
Do you presently have any breakage?
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No
Yes
Not sure
Please select any of the following chemical hair services you’ve received either professionally or at home.
In the past 3 years
Used box color (at home color remedy)
*
Please Select
Never
Less than 90 days ago
3-6 months ago
6-12 months ago
Just a reminder to please be honest, no judgment.
When was the last time you colored your hair professionally or at home?
*
Have you ever received a chemical straightener, relaxer service or any other non color treatments?
*
Yes, within the last month
Yes, within the last 6-12 months
No
Please feel free to go into more detail about any questions you may have for me.
*
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
I understand that in order to book any color appointments I will have to pay the $50 color deposit fee with in 24 hours in order to book my appointment
*
Yes
No
Have questions
Signature
*
Please take a couple hair selfies!
Please provide any inspiration photos
*
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Tell me what you like about your inspiration photo
*
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