NEW CLIENT REQUEST FORM
Full Name
First Name
Last Name
Email
example@example.com
Phone Number
Type of Hair Color Service
Full Custom Color
Partial Custom Color
Glaze
Root Touch-up
Pull Through Color
Haircut
Other
Desired color
Please upload a photo of your current hair
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Would you mind uploading an image of the hair color you want?
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Type of Hair
Straight
Curly
Wavy
Other
Current length of Hair
Short
Medium
Shoulder Length
Medium
Other
Hair Condition
Normal
Dry
Oily
Other
Scalp condition
Flaky
Dry
Itchy
Oily
Other
Where did you hear about this salon?
Facebook
Twitter
Instagram
YouTube
Online Advertisement
Google Search
Referred by a friend
Newspaper/Magazine
Other
When is the last time you visited a salon?
Date or any approximate weeks
How often do you come in to the salon?
Every month/Every 2 months/Quarterly/Yearly
Have you used a permanent color before?
Yes
No
Have you used a semi-permanent color before?
Yes
No
What shampoo and conditioner are you using?
Are you using any hair products? If yes, please list them below:
Are you pregnant? (Women)
Yes
No
Anything else I should know?
Are you comfortable in front of a camera? (ie: before and after pics, social media content etc)
Yes
Maybe
No, thank you
Do you consent to having your picture/video uploaded to social media/our website?
Yes
No
Cancellation Policy: To best serve all of our clients and keep our small business operating smoothly, we require a minimum 48 hours notice for appointment changes and cancellations. This gives us enough time to offer the opening to someone on the waitlist. No show/same day appointments will be billed 100% for the services reserved and late cancellations will be billed 50% for the services reserved. We understand that life is unpredictable and the policy is enforced within reason. A credit card number on file is required to secure appointment. Thank you for understanding and for your ongoing support
If you’ve consented, by signing below you agree to the release of your photo/video to social media/website. We will never post content anywhere than Instagram, Facebook or our website/google my business page.
Date Signed
-
Month
-
Day
Year
Date
Client's Signature
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