New Client Request Form
Hello! I'd love to know a little more about you to help you with your hair. Please complete the form and then I'll be in touch soon!
Name
*
First Name
Last Name
Email address:
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name on Facebook if you would like to connect:
Instagram Handle if you would like to connect:
How did you hear about me?
*
Please upload a current picture of your hair:
*
Browse Files
Drag and drop files here
Choose a file
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What Is Your Hair Type?
*
Straight
Curly
Wavy
Coiled
What Is Your Hair Density?
*
Thin/Fine
Medium
Thick
Is Your Hair Color Treated?
*
Yes
No
Is Your Scalp...
*
Oily
Dry
Normal
How Often Do You Wash?
*
Every day
Every other day
Every 3-4 days
Once a week
Is Dandruff or Flakiness an Issue?
*
Yes
No
My Hair Is... (select all that apply).
*
Dry
Limp
Frizzy
Brittle (breaks easy)
Damaged From Heat
Thinning
Receding (receding hairline)
Has Split Ends
Chemically Over-Processed
None of the above
Other
How Often Do You Apply Heat?
*
Never
Once in a while
2-3 times a week
Daily
How Do You Prefer To Style Your Hair?
*
Air-dried and Styled
Blow-dried and Styled
Only Air-dried
Only Blow-dried
Other
What Products Do You Use to Wash Your Hair?
*
What Products Do You Use to Style Your Hair?
*
What is Your Biggest Hair Concern?
*
What Are Your Ultimate Hair Goals?
*
Any Allergies to Chemical Services Or Products? If Yes Please Explain.
*
What are the best days and times to schedule an appointment?
*
Any other questions or concerns?
Please sign below confirming that all of the above information has been answered to the best of your knowledge.
*
Submit
Submit
Kat Roy
Follow Me on Instagram or Facebook: @HairLoveByKat | E-mail: HairLoveByKat@Gmail.com
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