Client Intake Form

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Welcome! ✨ I’m so happy you’re here ✨
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Name* This field is required.
First Name
Last Name
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Phone number* This field is required.
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Desired Service
Luxury Extensions
Crown Cleansing Ritual
Transformative Color Experience
Soma Flow Journey
Other
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Please upload a few photos of your current hair * This field is required.Please choose photos from gallery, do not take a photo or you will lose your information and have to start over
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
You can upload multiple files here
Cancelof
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Please upload multiple photos of your inspiration/hair goals* This field is required.Please choose photos from gallery, do not take a photo or you will lose your spot and have to start over
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
You can upload multiple files here
Cancelof
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What is your hair type?
Thin and fine
Medium thickness and fine
Medium thickness and course
Thick and fine
Thick and course
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Why are you booking this service?
Rejuvenation/Relaxation
To help with hair growth
Determine a scalp care plan to address issues
All of the above
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What is the current condition of your hair?
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Hair is dry
Damage due to lightening
Dandruff
Other
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Have you use the following in your hair in the last 3 years?
Permanent hair color
Keratin treatment
Razor cut/Thinning
Relaxer
Sun in
Box color
Henna
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Are you willing to come into the salon every 2-3 months for necessary hair maintenance? *Note: an appointment could be short and sweet (trim/ treatment), full color service, or crown cleansing with many options in between. We will chat about what is best for you!
Yes
No
If no, why?
Other
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Are you willing to invest in the recommended products to maintain hair/scalp health and color longevity?
Yes
No
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Once this application is submitted, I will reach out as soon as possible.

I'm so excited to begin this journey with you 💗
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Any special instructions, comments, or suggestions?
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Photo/Video Consent I consent and grant permission to Evoluirati LLC to have the coloring process and end result recorded and photographed for marketing, social media and website purposes
Yes
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Terms and Conditions* This field is required.
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By signing below, I agree to the terms and conditions of the salon company.
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Client's Signature
Clear
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Date Signed
Date
Month
Day
Year
Should be Empty: