New Guest Color Consultation
This survey will help me determine the best plan for your ultimate hair goals.
What is your name?
*
First Name
Last Name
What is your birthdate?
*
-
Day
-
Month
Year
Date
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
example@example.com
How did you hear about me? If referred, who can I thank?
*
Referral? Web search?
Have you ever had an adverse reaction to hair color? If yes, what was the reaction?
*
Itching, Swelling, Redness, Hives, Trouble breathing
What is your hair type?
*
Straight
Wavy
Curly
Coiled
What is your hair texture?
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Thin/Fine
Medium
Thick
Coarse
What is your hair density?
*
Very Thin
Somewhat Thin
Neither Thin nor Thick
Somewhat Thick
Very Thick
Is your scalp:
*
Oily
Dry
Normal
How oily does your scalp get within two days of washing?
*
Not Oily
Somewhat Oily
Very Oily
How often do you shampoo?
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Every day
Every other day
Every 3-4 days
Once a week
Is dandruff or flakiness an issue?
*
Yes
No
Somewhat
“My hair is...”
*
Dry
Limp
Frizzy
Brittle (breaks easy)
Damaged from heat
Thinning
Receding (receding hairline)
Damaged at the ends (split ends)
Chemically over-processed
None of the above
How often do you blow-dry your hair?
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Never
Once a week
2-3 times a week
4-5 times a week
Daily
How often do you use a curling iron or flat iron?
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Never
Once a week
2-3 times a week
4-5 times a week
Daily
How do you prefer to style your hair?
*
Air-dried and styled
Blow-dried and styled
Only air-dried
Only blow-dried
What products do you use to style your hair?
*
EXAMPLE: Leave-in Conditioner, Mousse, Smoothing Serum, Hair Spray
What brand of shampoo and conditioner are you currently using?
*
What brand of styling products are you currently using?
*
What is your biggest concern about coloring your hair?
*
What are your ultimate hair goals?
*
What is your natural hair color?
*
Dark Brown
Brown
Light Brown
Dark Blonde
Blonde
Light Blonde
Do you have any gray? If yes, what percentage of gray do you have?
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Less than 20%
20% - 40%
40% -60%
60 -80%
More than 80%
None
I want to ___________ my gray hair.
*
Completely cover
Blend in
I don't have gray hair.
I'm not concerned about gray coverage.
Have you colored your hair in the past 6 months? If yes, what was the service?
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Yes
No
All over Color
Bleach and Tone
Highlights
At home hair color
Have you had a chemical service in the past 6 months? If yes, what was the service?
*
Yes
No
Keratin Treatment
Perm
Relaxer
Other
How often are you willing/able to come to the salon to maintain your color and style?
*
Every 4 weeks
Every 6 weeks
Every 8 weeks
Every 10 weeks
12 weeks or longer
Other
How much time are you willing/able to spend in the salon per visit?
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Less than 1.5Hours
1.5 -2 Hours
2 - 3 Hours
3 Hours +
What are you willing/able to spend per visit to maintain your color and style?
*
Less than $100
$100 - $150
$150 - $$200
$200 +
Please upload a recent photo of yourself and a photo of your desired color.
Browse Files
Drag and drop files here
Choose a file
Please upload pictures if your desired color is drastically different than your current color.
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