Client Consultation
Please complete this form truthfully and in its entirety.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Birthday
-
Month
-
Day
Year
Date
Are you okay with being photographed?
*
Yes, but no face
Yes!
No thank you
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Are you pregnant or recently had a baby?
*
Yes
No
Recently had a baby
Do you have any existing conditions? (E.g., fungus, scalp conditions, nail damage)
*
Yes
No
If yes to the previous question, please explain
Do you have any medical conditions that may affect your service?
*
Are you taking any medications?
*
Are you allergic/ or sensitive to any product or scent?
*
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Signature
*
I understand that the salon technician will provide the service to the best of their ability, but results may vary depending on individual health and condition. I acknowledge that I have provided accurate information to the best of my knowledge and understand that any false information may affect the outcome of the service.
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