Hair questionnaire

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Instagram handle

5

What service are you looking to have done?* This field is required.

6

When was your last color service and what did you have done?* This field is required.(In salon or at home)

7

Have you had permanent color put in your hair in the past 3-5 years? (Professional, box, at home, demi permanent)* This field is required.

YESNO

8

Please provide a brief color history from the past 3 years.* This field is required.

9

How often would you like to have your hair done? * This field is required.

Once a year

Twice a year

3-4 times a year

6-8 weeks

10

Which of the following best describes your hair texture?* This field is required.

Extremely fine

Fine, but a lot of hair.

Medium / Average

Course / Very thick

11

Which of the following best describes the amount of hair you have?* This field is required.

Very little

Medium / Average amount of hair

Thick

Extremely thick

12

Which one best describes the overall health of your current hair?* This field is required.

Overall healthy

Healthy with a little dryness towards the ends.

Slightly damaged, growing back from a bad cut, color, or other damage.

Over processed / Very damaged from heat, chemicals or other damage.

13

Photo of your hair* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

14

Inspiration photo* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

15

Do you understand by filling out this form I may or may not be able to take you on as a new client?* This field is required.Please note I'm currently only accepting week day appointments. I'm currently not taking new clients after 3pm or Saturday. Thank you for understanding!

I agree

16

Do you understand that my pricing ranges from $200-450 and may vary on your hair and color goal?* This field is required.

I agree

17

Please list any areas of concern you'd like to discuss during your consultation.