New Client Intake Form
Welcome! Tell me about your dream hair!
Client's Name
*
First Name
Last Name
Client's Phone Number
*
Format: (000) 000-0000.
Client's Email Address
example@example.com
When is your Birthday?
Select a hair service
*
Women's Hair Cut
Color
Blow Dry
Gray Coverage
Updo
Balayage
Hair Extensions
Highlights
Keratin Smoothing
Other
Tell me about your hair goals
Upload an image of your hair inspiration
Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here
Cancel
of
Upload an image of your current hair
Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here
Cancel
of
How often do you go to salon for your hair?
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
Other
How long is your hair?
Please Select
Above Shoulder
Shoulder Length
Collar Bone
Chest
Mid Back
How does your scalp feel?
Please Select
Dry
Normal
Oily
What’s your hair texture like? Choose multiple to describe your hair
Straight
Wavy
Curly
Frizzy
Smooth
Fine
Thick
Delicate
Strong
Other
What is the current condition of your hair?
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Hair is dry
Dandruff
Other
Have you used the following in your hair before?
Permanent hair color
Keratin Treatment
Razor cut/Thinning
Relaxer
Henna
When was your last hair service?
-
Month
-
Day
Year
Date
Any special instructions, comments, or suggestions?
Print Form
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