CONSULTATION FORM

1

Name* This field is required.

2

Date of birth* This field is required.

Date

3

Age* This field is required.

4

Gender* This field is required.

Female

Male

Non Binary

5

Full Address* This field is required.

6

Phone* This field is required.

7

Email* This field is required.

example@example.com

8

How did you hear about us ?* This field is required.

Instagram

TikTok

Referral

Website

9

Would you like to be added to our email list for news and exclusive offers?* This field is required.

YESNO

10

Have you ever suffered from hair loss? If yes please explain* This field is required.

11

Have you ever been diagnosed with alopecia? If yes please explain* This field is required.

12

Do you take any medication that affects your hair ? If yes please explain* This field is required.

13

Please list any medications you take regularly including vitamins herbal supplements aspirin etc* This field is required.

14

Do you take any medication that affects your hair ? If yes please explain* This field is required.

15

Do you suffer from eczema on the scalp? If yes please explain* This field is required.

16

Do you have sensitive scalp? If yes please explain* This field is required.

17

Any other conditions* This field is required.

19

Last Hair Cut* This field is required.

Less than 4 weeks ago

1 - 2 months ago

2+ months

20

Received Services Before* This field is required.Select all that apply

Silk press

Chemical treatments

Hair treatments

Hair extensions

21

Hair Type* This field is required.

Fine

Medium

Thick

Very Thick

22

Hair Texture* This field is required.

Curly/Kinky

Straight

Wavy

Frizzy

23

Scalp* This field is required.

Oily

Dandruff

Dry

Normal

24

Hair Health* This field is required.

Greasy

Normal

Chemically damaged

Heat Damage

25

Length* This field is required.

Above shoulder

shoulder length or longer

Other

26

Frequently Swim Or Gym ?* This field is required.

YESNO

27

Currently Color Your Hair ?* This field is required.

YESNO

28

What does your daily routine look like* This field is required.

29

Hair goals* This field is required.

30

What Services Would You Like To Perform Today?* This field is required.

Start My Healthy Hair Journey

Wig Install

Quick Weave

Sewin

Protective style prep (Hair Treatments)

Other

31

Comments or concerns* This field is required.

32

I hereby consent to and authorize Shay'Onna To Service following procedurs: Lace Applications Using Lace Glue , Quick Weave, Sewins, And Ponytails

I acknowledge that hairstyling inherently carries some risk, and I may potentially experiencediscomfort, skin irritation, or other adverse effects as a result of the styling services provided.

I confirm that I have openly and fully disclosed to Shayonna/ Mooreliife all relevant medical conditions, allergies, and any other important health-related information that could affect the hairstyling services.

I hereby release, waive, and discharge Shayonna/ Mooreliife, its employees, agents, representatives, and assigns from any and all claims, demands, damages, actions, or causes of action that may arise as a result of the hairstyling services provided to me.

I consent to absolve Shayonna/ Mooreliifefrom any and all liability, including, but not limited to, liability arising from the negligence ofShayonna/ Mooreliife, its employees, agents, representatives, or assigns.

I am aware that this Hairstyling Consent and Liability Form will be maintained on record by Shayonna/ Mooreliife and will remain valid until I decide to revoke it.

By signing below, I herby acknowledge that I have completely read and fully understand the above agreement.

33

In order to ensure the provision of high-quality care within a reasonable timeframe, we have implemented an appointment and cancellation policy.

As appointments are in high demand, canceling your appointment in advance allows us to offer the time slot to another individual seeking timely care. This policy helps us optimize our appointment availability for all

During the appointment booking process, you will be required to make a 35% deposit, which will be applied as a credit towards your scheduled treatments.

We understand that circumstances may arise requiring you to cancel or reschedule your appointment. To avoid any inconvenience, please notify us at least 24 hours prior to your scheduled appointment. In such cases, your deposit will either be refunded or applied towards a future appointment. However, if you provide less than 24 hours' notice, your deposit is forfeited unless stated otherwis.

Please note that if you arrive more than 30 minutes late for your appointment, it will be considered a no-show and the cancellation fee will be applied.

We are more than happy to address any inquiries or concerns you may have regarding our cancellation policy.

I have read and fully understand the above Appointment Cancellation Policy and agree to be bound by its terms. I agree to pay the cancellation fee in the event of a missed appointment.

34

Client signature* This field is required.

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35

I grant Shayonna the right to capture, modify, edit, reproduce, exhibit, publish, distribute, and utilize any photographs, videos, and/or audio recordings taken of me for lawful promotional purposes. These materials may include, but are not limited to, newspapers, flyers, posters, brochures, advertisements, press kits, websites, social media platforms, and other forms of print and digital communication. I provide this authorization without expecting any payment or other forms of consideration.

This authorization remains in effect indefinitely and applies to all languages, media, formats, and markets, whether currently known or discovered in the future.

I willingly waive any rights to royalties or other compensation arising from or related to the use of these photographs or recordings.

I acknowledge and accept that the materials created through this agreement will be the property of the Shay'Onna

and will not be returned to me.

from any liability, claims, or I hereby release and discharge the legal actions that may arise, including those made by myself, my heirs, representatives, executors, administrators, or any other individuals acting on my behalf or on behalf of my estate.

By signing below, I confirm that I have thoroughly read and comprehended the entirety of the release agreement stated above. By signing below, I hereby acknowledge that I have completely read and fully understand the above release agreement

36

Type a question* This field is required.

YESNO

37

Client signature* This field is required.By signing below, I hereby acknowledge that I have completely read and fully understand the above release agreement

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