Premier 1 on 1 Salon Client Intake Form

Premier 1 on 1 Salon Client Intake Form

Thank you for Booking with us! Your hair care matters to us! Filling out this form helps us to provide the best service your hair needs. Please NOTE - WE DO NOT DO COLOR SERVICES ON YOUR FIRST VISIT!! WHY?? Because we need to establish a relationship and get to know your hair as well as hair history. This is why this form is important to fill out!! EVERYONE IS REQUIRED TO FILL OUT FORM ONCE TO HAVE ON FILE - IN ADDITION YOU MUST CONFIRM ALL APPOINTMENTS TO AVOID AUTOMATED CANCELLATION. This helps us avoid No-Shows THANK YOU - WE LOOK FORWARD TO SERVICING YOU!🥰
Client's Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Client's Phone Number
Format: (000) 000-0000.
Client's Email Address
example@example.com
Occupation
Select a hair service
What hair style do you like?
Upload an image of hair style or hair color you prefer

You can upload multiple files here
Cancelof
Upload an image of your current hair

You can upload multiple files here
Cancelof
How often do you go to salon for hair treatment?

Other
How long is your hair?

Other
What is the current condition of your hair?

Other
What is the condition of your scalp?

Other
How often do you apply shampoo and conditioner in your hair?

Other
Have you use the following in your hair before?
When did you last visit a hair salon?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
When did you last apply professional or unprofessional color in your hair? Or any other chemical service such as relaxer, keratin, etc..
Are you taking any medications? If yes, please list them below: (this information helps with outcome of service & if you are experiencing breakage, shedding, or hair loss)
Kindly list the hair products that you are using
What are the tools you are using to style your hair?
How did you hear about us?

Other
Any special instructions, comments, or suggestions?
By signing below, I agree that all information is true to the best of my knowledge. In addition to understanding information provided helps stylist @ Premier 1 on 1 Salon to perform hair care service requested.
Client's Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: