At Home Hair Care Regimen Consultation Form

At Home Hair Care Regimen Consultation Form

SOFT TOUCHED SALON
Name

First NameLast Name
Email
example@example.com
OPT-in for emails list to receive information and offers
How often do you go to salon?

Other
Are you natural?
What is your hair porosity?
What is your hair type?
How often do you shampoo your hair?
How often do you deep condition/treat your hair?
How often do you trim your hair?
Kindly describe the status of your scalp.

Other
Do you have any scalp issues or concerns?
How would you describe the current health of your hair?
Describe your hair by checking the options below: (You can select more than one)

Other
What styling methods do you typically use? Please list all.
Do you use heat on your hair? If yes, how often?
When did you last apply professional or unprofessional color in your hair?
Do you have any hair loss problems in the past?
Are you currently taking any medications? If yes, please list them below. If not, please put N/A.
Please indicate the list of hair products you're currently using:
What are your hair goals?
Upload 2-3 clear pictures of your hair (dry, wet, and/or scalp)(Helps customize product recs and regimen better!)

You can upload multiple files here
Cancelof
Packages:
Apple Pay (404)242-2323 Zelle hairbyzairak@gmail.com
Client Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Apple Pay (404)242-2323 Zelle hairbyzairak@gmail.com