Guest Intake Form

Guest Intake Form
Guest's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Guest's Phone Number
Guest's Email Address
example@example.com
Select a hair service

Hair ExtensionsHair CutHighlightsBalayageSingle ProcessColor CorrectionHair styling (Special Occasion)Highlights
Please upload unfiltered photos of your current hair and your inspo photos. This allows us to prepare for your appointment so we can assess the steps it will take to achieve your dream hair.

You can upload multiple files here
Cancelof
How often do you go to salon for color services?

Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a yearOther
How long is your hair?

ShortMediumLongOther
What is the current condition of your hair?

Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruffOther
What is the condition of your scalp?

DryNormalOilyOther
How often do you apply shampoo and conditioner in your hair?

Every dayEvery other dayTwice a weekOnce a weekOther
Is your hair color treated?

YesNo
When did you last visit a hair salon?

MonthDayYear
Date
When did you last apply professional or unprofessional color in your hair?
What products do you use to style your hair with?
What are your biggest concerns/issues with your hair?
How did you hear about us?

FacebookInstagramGoogle SearchNewspaper/MagazineReferred by a friend
Any special instructions, comments, or suggestions?
I understand that due to the nature of our business and wanting to give all our guest a luxury experience, no children will be allowed in the salon unless they are receiving a service. If your child is unable to sit for the duration of your service, seperate appointments will need to be made.*

Yes
I am allowing the hairstylist and Lotus Hair Company to apply the necessary chemicals as part of my hair service. I release Lotus Hair Company of all reliability of skin reactions that may be caused if I do not have a dermatologist list of chemicals I may or may not have reactions to.**

Yes
Lotus Hair Company understands that sometimes schedules change and therefore requests at least 24 hours notice when canceling or rescheduling your appointment. Appointments canceled within 24 hours or for which clients are a “No-Show” will incur a charge of 50% of the service amount.*

Yes
I give Lotus Hair Company consent to charge my card on file the " no show " or " late" cancellation fee as stated above.
I understand that all services performed are non refundable. If there are any issues please reach out to your stylist within 7 days of your service date to fix your concerns for complete satisfaction.*

Yes
Client's Signature

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Date Signed

MonthDayYear
Date
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