Hair Consultation Form
Jess Muraro
Select a hair service
Consultation (prior chair work, color correction, going grey)
Cut and Style
Clipper Cut
Fringe Trim
Color Balance (grey coverage or non grey coverage)
On scalp color (grey coverage with Foil work
Full Foil
Foilayage
Partial Foil
Color correction
Going Grey
Keratin Express
Brazilian Blowout
Brow Wax
Lip wax
Bellami Volume Weft Extensions
Other
What hair style do you like?
Upload an image of hair you prefer
Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here
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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 treatment?
Every 2 weeks
Every 3-4 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
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 used the following in your hair before?
Permanent hair color
Keratin Treatment
Razor cut/Thinning
Relaxer
Henna
Over the counter chemical products such as color, at home toner, Sun In/Sun Bum
When did you last visit a hair salon?
-
Month
-
Day
Year
Date
When did you last apply professional or unprofessional color in your hair?
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
Online Advertisement
Google Search
Referred by a friend
Other
Any comments, or suggestions?
Salon Polices
Date Signed
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Client Signature
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
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