Color Consultation Form
This consult is for those interested in receiving any form of color service(s). Every detail is very important as it can affect timing, price, and outcome of your service.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Have you ever had color, highlights, glaze, or henna in the last 5 yrs? If so, please describe below what service you've received and when.
*
Have you ever had any texture altering service i.e. relaxer, texturizer, perm, Keratin treatment in the last 5 years? If so, please describe service received and when.
*
Are you unhappy with the state of your current color as a result of a past salon visit or at-home product added to your hair? Tell me what you do not like. If it was an at-home product used, please give me as much details as possible about what was used.
*
Are you currently pregnant or can possibly be pregnant?
*
YES
NO
Are you currently on any medication relating to high blood pressure, immune-deficiency diseases, cancer treatment, hormone altering medications (like birth control), Retin-A or are you vitamin deficient, enough to be treated with prescription vitamins? If so, please list type of medication you are currently taking.
*
Have you had any surgery recently or procedures that warranted the use of general anesthesia? If so, when was the procedure performed?
*
-
Month
-
Day
Year
Date
Please upload current pics of your hair from different angles- front, back, and side.
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of
Please upload pics of the look you are going for.
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I understand that a deposit of $100 may be due if the color appointment needed will be 3 hours or longer. This deposit will be applied to my service. If for any reason I miss my scheduled appointment or fail to give 72-hour notice to change my appointment, I will forfeit my $100 deposit. All information disclosed above is true to the best of my knowledge. I understand that any previous chemical services were disclosed. I understand that all information given is important to ensure the best results and will be held in the strictest of confidence.
*
I AGREE
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