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
Date
Client's Phone Number
Format: (000) 000-0000.
Client's Email Address
example@example.com
Occupation
Adult Hair CutCut & ShampooHair color (Permanent)Hair color (Semi)Hair Color BlendingHair ConditioningHair styling (Formal)Hair styling (Special Occasion)PermsRelaxersRetexturizingHighlightsMake UpNail Care
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
Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a yearOther
ShortMediumLongOther
Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruffOther
DryNormalOilyOther
Every dayEvery other dayTwice a weekOnce a weekOther
Permanent hair colorKeratin TreatmentRazor cut/ThinningRelaxerHenna
When did you last visit a hair salon?

MonthDayYear
Date
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?
FacebookTwitterInstagramYouTubeOnline AdvertisementGoogle SearchReferred by a friendNewspaper/MagazineOther
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

Clear
Date Signed

MonthDayYear
Date
Should be Empty: