Client Consultation
Please complete this form truthfully and in its entirety.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
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, 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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