New Client Questionnaire
Hi! We'd like to get to know you a little bit better before we spend some time together in the salon. Please answer the questions below so that we can be better prepared for your service.
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Birthday
-
Month
-
Day
Year
Date
Back
Next
Medical History
Please list any known allergies: *
*
If none, please write "None."
Please list any current medications: *
*
If none, please write "None."
Are you pregnant or taking prenatal vitamins? *
*
Yes
No
Have you ever experienced sensitivity to any hair color service? *
*
Yes
No
If yes, please explain:
Your Hair Profile
What are your hair goals?
*
Examples: I’m growing my hair, I want to go lighter, I want to go darker, I’m growing out a bad haircut, etc.
Please upload an example of what you have in mind:
Browse Files
Haircut inspiration 1
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Please upload an example of what you have in mind:
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Haircut inspiration 2
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Please upload an example of what you have in mind:
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Color inspiration 1
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Please upload an example of what you have in mind:
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Color inspiration 2
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What does your hair currently look like?
Browse Files
Front selfie to show what the hair looks like from the front
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What does your hair currently look like?
Browse Files
Back selfie to show what the hair looks like from the back
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What are your hair care challenges? *
*
No volume
Too thick
Too thin
Dryness
Oily
Dull
Breakage
Frizziness
Won't stay curled
Curl management
No challenges
What are you trying to achieve with your style?
More Volume
Control curls
Less curves
Straight
Less Frizz
Easy to manage style
Other
How much time do you spend styling your hair after you wash it?
Less than 15 minutes
Up to 30 minutes
Up to 45 minutes
More than 1 hour
What is your home styling comfort level?
Very comfortable
Comfortable
Uncomfortable
I want some tips!
What kind of styling tools are you using at home? *
Flat iron
Curling iron
Blowdryer
None
Other
What are you wanting to achieve with your hair appointment?
Extension Consultation
Cover gray
All over color
Refresh highlights
Brand new highlights
Lived in color (Balayage)
Refresh Glaze (Toner)
Maintenance Haircut
Big Change Haircut
Bangs Trim
Complete Makeover (color, cut, dimension, etc)
Please go into more detail about any questions you may have for your stylist.
Current Hair Products and Hair History
How often do you wash your hair? What shampoo/s and hair conditioner/s are you using?
*
Styling Products:
*
Heat Products:
*
Other:
Is your hair colored now?
Was it done in a salon?
Please Select
Yes
No
Not Applicable
What was your hair color before that?
Was it done in a salon?
Please Select
Yes
No
Not Applicable
And what was your hair color before that?
Was it done in a salon?
Please Select
Yes
No
Not Applicable
Have you ever used box color? *
Please Select
Never
Less than 3 months ago
3-6 months ago
6-12 months ago
12+ months ago
Have you ever used henna color? *
Please Select
Never
Less than 3 months ago
Have you ever received a chemical straighter, relaxer service or similar treatment? *
Yes, within the last month
Yes, within the last 6-12 months
No
Please go into more detail about any questions you may have for your stylist:
I understand that chemical services can result in hair damage such as breakage, color alteration and/or permanent change of texture. I agree to hold the salon and the hair technician harmless in the event of unexpected or undesired results. I understand that any further alterations or corrections will be provided at my own expense. *
*
Yes
I understand that chemicals can damage my jewelry, clothes and/or accessories and I will dress accordingly for my appointment. I understand that the salon and the hair technician is not liable for any accidental damages. *
*
Yes
I understand, have read and completed this questionnaire truthfully. I understand that previous treatments and/or chemical services can affect the outcome of my desired results. I have fully disclosed all requested information related to my hair history. I understand that withholding information or providing misinformation may result in contradictions and/or irritation to the hair service being received. *
*
Yes
Signature
Submit
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