Consultation Form
Select a service
*
Cutting
Styling
Coloring
Hair Treatment
Other
Personal Information
Full Name
*
First Name
Last Name
Email
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you pregnant?
Yes
No
Preferences
Preferred Stylist
Please upload a photo of your current hair
*
Browse Files
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of
Please upload the hair style that you want
*
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What shampoo and conditioner are you using?
Are you using any additional hair products? If yes, please list them below:
Are you currently taking any medications? If yes, please identify them below: (some medications may effect hair)
Hair Condition and History
Type of Hair
Straight
Curly
Wavy
Other
Current length of Hair
Short(ear length)
Medium (shoulder length)
Long (past sholders)
Other
Hair Condition
Normal
Dry
Oily
Other
Scalp condition
Flaky
Dry
Itchy
Oily
combo
Other
On a scale of (least amount of change)1-10(most amount of change) how much change are you looking for?
How often do you go to 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
Other
When is the last time you visited a salon?
Have you used a permanent color or semi-permanent color before?
Yes
No
In the past 3 years if you have colored your hair at home, please describe. (type of color/brand/how long ago)
*
Where did you hear about this salon?
Facebook
Instagram
Online Advertisement
Google Search
Referred by a friend
Other
Any special instructions?
Would you be interested in continuing this consultation via:
Email
Phone call
In salon
No preference
Date Signed
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Client's Signature
Submit
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