La Birdie Hair
New Client Questionnaire
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How Did You Hear About My Salon?
*
Please Select
Google Search
Social Media
Letterbox Promotion
Word of mouth
Select all the services your interested in booking with me
*
Lived-In Blonde
Lived-In Brunette
Highlights (Face-Framing Foils)
Foils (Half Head)
Foils (Full Head)
Grey Coverage
Grey Blending
Gloss/Tone
Colour Correction
Trim
Restyle
Blowave
How often do you typically like to visit the salon?
*
Every 4-6 weeks
Every 6-10 weeks
Every 10-16 weeks
Twice a year
Once a year
Do you have greys, if so what percentage?
Please Select
25%
50%
75%
100%
Have you used any of the following on your hair (professional or not) in the past 3yrs?
*
Professional permanent hair colour
Box Dye
Highlights/Balayage/any type of bleach work
Henna
None of the above
What’s the texture of your hair? (check all that apply)
*
Fine/Thin
Average
Thicker than average
Extremely thick
Course
Frizzy
Dead straight
Curly/Wavy
Ringlet Curls
How long is your hair?
*
Short
Chin Length
Shoulder length
Past shoulders
What is the current condition of your hair/scalp? (check all that apply)
*
Minimal split ends, just in need of a trim
Significant breakage (due to heat or chemical damage)
Some old colour but generally pretty healthy
Struggling with hair-loss
Dry/Itchy scalp
Do you have any known allergies/reactions to anything including chemicals/hairdyes?
*
Yes
No
If yes please describe below.
Please give a brief hair history summary:
*
Please upload some clear images of your current hair. Preferably including the front, sides, back and top.
*
Browse Files
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Please describe your current hair goals to the best of your ability:
*
Please upload images of your hair inspiration of what you’d like to achieve
*
Browse Files
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Choose a file
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of
Anything else you'd like me to know?
Submit
Should be Empty: