Hair Salon Client Intake Form

Virasana Salon Client Intake Form
Client's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Client's Phone Number

Area CodePhone Number
Client's Email Address
example@example.com
What hair styles do you like? What do you dislike?
We have two salon dogs (frenchies), they take turns being here but if you prefer a dog free experience just let us know below!
If you get highlights, do you prefer them to be more defined or blended? Do you like bright pieces at the root or do you like your lightness at the end of your hair?
What is your natural root color?
Do you prefer a cooler or warmer hair color? Do you feel like your current color is warmer or cooler in tone?
Tell me about your current haircut, what do you like and what do you dislike?
Is there a time you remember when you really disliked your haircut? Tell me about that.
Do you like your layers throughout your cut or more through the bottom only?
Do you like the bottom of your cut to be more precise or more textured?
Do you normally blowdry, flat iron, or curl your hair? How many days a week do you heat style your hair?
How often do you wear your hair up in a ponytail?
Upload an image of hair style or hair color you prefer

Browse Files
You can upload multiple files here Cancelof
Upload an image of your current hair

Browse Files
You can upload multiple files here Cancelof
How often do you go to salon for hair treatment?

Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a year
Have you been getting highlights?

Face frame highlightPartial highlightFull highlight
How long is your hair?

ShortMediumLong
What is the current condition of your hair?

Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruff
What is the condition of your scalp?

DryNormalOily
How often do you apply shampoo and conditioner in your hair?

Every dayEvery other dayTwice a weekOnce a week
Have you used the following in your hair before?

Permanent hair colorKeratin TreatmentRazor cut/ThinningRelaxerHenna
When did you last visit a hair salon?

MonthDayYear
Date
When did you last apply professional or unprofessional color in your hair?
Are you taking any medications that may affect your hair growth or it's ability to lift? If yes, please list them below:
Kindly list the hair products that you are using including Rogaine.
What are the tools you are using to style your hair?
Did our website influence your decision to book with us?

YesNo
How did you hear about us?

FacebookInstagramYou Found Our WebsiteGoogle SearchReferred by a friendNewspaper/Magazine
Any special instructions, comments, or suggestions?
SERVICE REDO & RETAIL RETURN POLICY: Virasana Salon does not offer refunds on services or products, but strives to offer you the highest level of guest satisfaction. If you are having challenges with your cut or color, let me know within 7 days of your visit and I'm happy to correct the issue with no additional charge. Should you make a retail purchase that you are unsatisfied with, products can be exchanged for something else of equal or lesser value within 14 days of purchase.

FUTURE APPOINTMENT CANCELLATION POLICY: In order to continue providing the best possible scheduling options to my guests, I require 48 hours' notice should you need to cancel or reschedule your visit with me. Should you cancel your appointment with less than a 24 hour notice we reserve the right to charge up to 100% cost of service fee. Please respect our time as we will always respect yours.

By signing below, I agree to the terms and conditions of Virasana Salon.
Client's Signature

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Date Signed

MonthDayYear
Date
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Virasana Salon Client Intake Form