New Color Client Intake Form
Alchemy 79 Salon
Client's Name
First Name
Last Name
Client's Phone Number
Format: (000) 000-0000.
Client's Email Address
example@example.com
What services are you interested in?
All over color (dark or grey coverage)
Gloss (Semi permanent)
Highlights
Blonding Tranformation
Corrective Color
Vivid / Fashion Colors
Upload at least one current photo of your hair (no filters)
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Upload an image(s) of your inspiration/goal hair color. If you are unsure, please upload a couple photos of hair that you love:
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How often are you wanting to come in for maintenance?
Every 4-6 weeks
Every 2 months
Every 3 months
Twice a year
Once a year
Other
What is the density of your hair?
Fine/Thin
Medium
Thick
Extra Thick
Do you have any of the following:
Hair loss
Heat Damage
Chemical Damage
Split ends
Breakage
Itchy scalp
Hair is dry
Dandruff
What is the condition of your scalp?
Dry
Normal
Oily
Other
How often do you apply shampoo and conditioner in your hair?
Every day
Every other day
Twice a week
Once a week
Other
Please list the brands and products you use regularly (shampoo, conditioner, oils, etc.)
Have you use the following in your hair in the last 2 years?
SunBum or other spray lighteners
Keratin Treatment
Relaxer
Henna
Splat hair color
Box dye or Sally’s dye
How long has it been since your last color/chemical service? Please list what service(s) you received:
In detail, tell me about the last time you had your hair colored or chemically changed:
Is there anything else you would like me to know about you or your hair?
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