Client Consultation

Client Consultation

Please provide is with as much information as possible to ensure we give you the best possible experience at NovaLux
It is important we have an accurate record of your general health, including any allergies and medications you are taking, this is because certain health conditions may indicate that a particular service, product or piece of equipment is not suitable for you. If so we will try and suggest alternatives where possible.

If the client is under 16, this information must be completed with the permission of the parent, carer or guardian.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about us?
Are you on any medication? *
Have you any scalp or skin conditions? If so please provide details.*
Do you suffer with any allergies? If so please provide details.*
Have you ever had an allergic reaction to professional hair colour? If so please provide details. *
Have you ever had an allergic reaction to a tattoo? If so please provide details *
Do you regularly use a swimming pool or hot tub? *
How do you feel about your hair today? *
Do you have any problems with the condition of your hair and/or scalp? *
How often do you wash and style your hair? *
What is your daily routine with your hair? *
Do you colour your hair? If so when was the last time it was professionally coloured? *
Have you ever had your colour analysis done? *
What do you normally like to use with cleansing and conditioning products? *
Is there any other information you would like to share with your stylist? *
We take your privacy seriously and the information We collect about you will be held confidentiality and in compliance with data protection laws and will NOT be shared with 3rd parties.
PLEASE TICK THE BOX BELOW IF YOU CONSENT TO US:

Keeping a record of your personal information while you are our clientHolding records of your personal information for 2 years after your last visit, after which your records will be deleted (unless we are required by law to keep your personal information for longer)
We quite often like to take pictures of our work, if you do not wish for us to take pictures we completely understand, you can discuss this with your stylist.
Declaration*

I have read and understood the questions above, and to the best of my knowledge the answers are correct.I understand that I am responsible for informing the stylist of medical or health conditions and that I may not be able to have the service(s) I have requested to protect my wellbeing.
Signature*
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