JillPaintsDenver New Client Intake Form
I look forward to getting to know you
Please allow 48-72 buiness hours to reply
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email Address
example@example.com
Occupation
Instagram Handle
Select a hair services that apply
Lived in Blonde
Hair Color Blending
Lived in Brunette
Grey Coverage
Lived in Bronde
Hair Conditioning
Traditional Highlights
Hair Cut
Hair color (Semi)
Toner
Sew in Extensions length
Sew in Extensions Volume
Tape-In Extensions to fill in sides
Color Correction
Other
What is your goal/dream hair?
Upload an images of your hair inspiration
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Upload an image of your current hair in INDIRECT sunlight. No bathrooms or kitchen lighting please. In front of a window or on covered patio is best. Front, Back, Sides.
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How often do you go to salon?
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
Other
I work Tuesday, Wednesday, and Friday. What days and time of day work best for you?
Tuesday
Wednesday
Friday
Morning
Afternoon
Late Afternoon/ Early evening
I'm Flexible
How long is your hair?
Short
Medium
Long
Other
What is the current condition of your hair?
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Hair is dry
Dandruff
Virgin
Healthy
Other
What is the condition of your scalp?
Dry
Normal
Oily
Other
How often do you shampoo and conditioner in your hair?
Every day
Every other day
Twice a week
Once a week
Other
Have you use the following on your hair in the past two years?
Permanent hair color
Keratin Treatment
Razor cut/Thinning
Relaxer
Henna
Balayage
Babylights
Highlights
None/Virgin
Semi Permanent Color
Brazilian Blowout
Other
When did you last visit a hair salon?
-
Month
-
Day
Year
Date
When did you last apply professional or unprofessional color in your hair?
Are you taking any thyroid medications?
Kindly list the hair products, including shampoo, and conditioner that you are using
What are the tools you are using to style your hair?
How did you hear about us?
Facebook
Instagram
Online Advertisement
Google Search
Referred by a friend
Newspaper/Magazine
Other
Any special instructions, comments, or suggestions?
By signing below, I agree to the terms and conditions of the salon company.
Client's Signature
Date Signed
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Month
-
Day
Year
Date
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