Hair Consultation Form
Pick Beauty Co.
Select a hair service
*
Haircut
Grey Coverage
Partial Highlight
Hair Treatment
Full Highlight
Special Occasion Styling
Extensions
Other
DESIRED APPOINTMENT DATE:
Date
*
Stylist you would like to see
*
Emily
Kyleigh
Maggie
Kenedy
No Preference
Client's Name
*
First Name
Last Name
Client's Phone Number
*
Format: (000) 000-0000.
Client's Email Address
*
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Preferred method of contact
*
Email
Text
Call
Upload an image of hair you prefer
*
Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here
Cancel
of
Tell us something about your hair
Upload an image of your current hair
*
Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here
Cancel
of
How often do you go to salon for hair services?
Every week
Every 2 weeks
Every 4-6 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
Other
How long is your hair?
Please Select
Short
Medium
Long
Kindly describe the status of your scalp.
Please Select
Dry
Normal
Oily
How often do you apply shampoo and conditioner in your hair?
Every day
Every other day
Twice a week
Once a week
Other
What is the current condition of your hair?
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Hair is dry
Dandruff
Other
Have you use the following in your hair before?
*
Permanent hair color
Keratin Treatment
Relaxer
Henna
Fashion Colors
Semi Permanent Color
When did you last visit a hair salon?
*
-
Month
-
Day
Year
Date
When did you last apply professional or unprofessional color in your hair and what was it?
*
When was the last time you had unprofessional color on your hair? For example, sun in or Sally’s color
*
Do you have any hair loss problems in the past?
Please indicate the list of hair products you're currently using:
How did you hear about us?
*
Facebook
Instagram
Google Search
Referred by a friend
Other
Any special instructions, comments, or suggestions?
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: