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17
Questions
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1
Name
*
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First Name
Last Name
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2
Email
*
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example@example.com
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3
Phone Number
*
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Please enter a valid phone number.
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4
First time visit?
*
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YES
NO
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5
Are you an out of state client?
*
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YES
NO
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6
How would you describe the current state of your hair?
*
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Naturally curly
Relaxed or permed
Natural silk press
Colored or bleached of any kind
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7
Upload a photo of your hair in it’s natural state.
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8
what hair service are you interested in?
*
This field is required.
Please Select
Luxury Silk Press
Shampoo & blowout
Healthy Hair & Skin Program
Please Select
Please Select
Luxury Silk Press
Shampoo & blowout
Healthy Hair & Skin Program
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9
Have you ever had a Silk press?
*
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YES
NO
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10
What is the length of your natural hair?
*
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Short (earlobe, chin or above shoulder length)
Medium (on or at the shoulders)
Medium to long (below shoulders to bra length)
Long to extra long (lower back to hip length)
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11
What density is your hair?
*
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Fine/thin
Medium
Coarse/thick
Fine & medium
Medium & coarse
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12
What is your natural curl pattern?
*
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Straight 1A-1C
Wavy 2A-2C
Curly 3A-3C
Kinky curly 4A-4B
Coily-kinky straight 4C
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13
What condition is your hair currently?
*
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Healthy (no split ends, no damage)
Thinning/shedding
Heat damage
Hair loss
Breakage of any kind
Dry/itchy scalp
Brittle/hard/dry hair
Scalp build up/skin sensitivity
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14
Please describe what you would like to see differently for your hair?
*
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Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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15
Do you agree to follow Nyce N’ Chic recommended use of hair and skin care regimen/ or products for best results?
YES
NO
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16
Upload a photo of inspiration or your desired look.
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17
Signature
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