Hair Color Client Intake Form

Hair Color Client Intake Form

Thank you for choosing me, to craft your dream hair! Please fill out the form below if we’ve talked about a consultation or you already have an appointment. This way I get to know a little bit more about you and your hair goals. Can’t wait to make your hair dreams come true!
Client's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Client's Phone Number*
Format: (000) 000-0000.
Client's Email Address*
example@example.com
Occupation
HaircutBase/all over colorHighlightsGray coverageColor correctionBalayageExtensionsOther
What was your last color service? How often do you typically color/chemically treat your hair? *
Upload an image of hair style or hair color you prefer*

You can upload multiple files here
Cancelof
Upload an image of your current hair*

You can upload multiple files here
Cancelof
Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a yearOther
ShortMediumLongOther
Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruffOther
FineMediumThickOther
Very straightStraight with slight wavesWavyCurlyOther
DryNormalOilyOther
Every dayEvery other dayTwice a weekOnce a weekOther
Every day3-4 times per week1-2 times per weekOnce every week or twoOnce per monthNever
Permanent hair colorKeratin TreatmentRazor cut/ThinningRelaxerHenna
When did you last visit a hair salon?

MonthDayYear
Date
When did you last apply professional or unprofessional color in your hair? How was your experience?*
Are you taking any medications? If yes, please list them below:
Describe current hair care routine. (Shampoo, conditioner, hair treatments, etc)*
What are your hair goals? What are you looking to achieve?
FacebookInstagramYouTubeOnline AdvertisementGoogle SearchReferred by a friendOther
Any special instructions, comments, or suggestions?
By signing below, I agree to all cancellation and other salon policies.
(click here for Cancellations & Policies)
I understand that not all services may be possible given previous color or condition of my hair.
Agree
Agree
Yes, I’m okay with taking pictures/videosNo, I do not want to be taken any pictures/ videos
Client's Signature

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Date Signed

MonthDayYear
Date
Should be Empty: