Your Mane Chick New Client Intake Form

Your Mane Chick New Client Intake Form
Please fill this out to the best of your ability.
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
When is the last time your hair was colored and was it done professionally or by yourself/friend?
What do you like about your hair?
What do you dislike about your hair?
When is the last time you had it trimmed/cut?
How much time to you spend styling your hair?
How would you rate the current condition/health of your hair?

1

2

3

4

5

1 is Worst, 5 is Best
How often do you wash your hair?
What best descibes your hair? Check all that apply.
Please select all that youre looking to have done.
How often are you willing to come in for maintenance? There's no wrong answer
Please include some current pictures of your hair as well hair goal pictures. If you're not tech savy you can text or email your pictures to me if that's easier for you.

Cancelof
How did you hear about me?
Should be Empty: