New Client Consultation Form

Haircolor Appointment Questionaire
Name*

First NameLast Name
Phone Number
Email (we do not share info.)*
example@example.com
How did you hear about Great Hair Day?*

Website / Online SearchGoogleFacebookReferralInstagram
If Referral, please list name
If Other, please let us know
Your Hair Profile
What are your hair care goals? *
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?*

VolumeCurlStraightChange of HaircolorOther
Average visits to a salon:*

every 6 weeksEvery 6-12 weeksEvery 3-6 monthsOnce a year
What are your morning hair rituals?
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, thinning or bald spots?*

NoYesNot sure
Please select any of the following chemical hair services you’ve received either professionally or at home.
Used box color (at home color remedy)
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*

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Upload some desired Hair results
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Haircolor Appointment Questionaire

Your Hair Profile

Hair History

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