Client Request Form

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 NameLast Name
Email address:*
example@example.com
Phone Number
Please enter a valid phone number.
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:

Cancelof
What Is Your Hair Type?*

StraightCurlyWavyCoiled
What Is Your Hair Density?*

Thin/FineMediumThick
Is Your Hair Color Treated?*

YesNo
Is Your Scalp...*

OilyDryNormal
How Often Do You Wash?*

Every dayEvery other dayEvery 3-4 daysOnce a week
Is Dandruff or Flakiness an Issue?*

YesNo
My Hair Is... (select all that apply).*

DryLimpFrizzyBrittle (breaks easy)Damaged From HeatThinningReceding (receding hairline)Has Split EndsChemically Over-ProcessedNone of the aboveOther
How Often Do You Apply Heat?*

NeverOnce in a while2-3 times a weekDaily
How Do You Prefer To Style Your Hair?*

Air-dried and StyledBlow-dried and StyledOnly Air-driedOnly Blow-driedOther
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.

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Kat Roy

Follow Me on Instagram or Facebook: @HairLoveByKat | E-mail: HairLoveByKat@Gmail.com
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New Client Request Form

Kat Roy