BLUSH ARTISTRY SALON SERVICES Hair Consultation Form

Select a hair service:*

Shampoo & Blow OutBlushing Curls Wash & GoSingle Process ColorBlushing Curls Silk PressRoot Touch UpBlushing Hair CutTone ONLY ServiceCurly Cut & Style ExperiencePartial Highlight/Halo (Up to 25)foilsFull HighlightTape-In ExtensionsK-Tip Extensions (Keratin Bonds)Weft Extensions (Beaded Row)I-Tip Extensions (Beaded Individual Strands)

How did you hear about us?*

Client's Name*

First NameLast Name

Client's Phone Number*

Format: (000) 000-0000.

Client's Email Address*

example@example.com

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Format: (000) 000-0000.

Client Occupation*

Date of Birth*

Date

Are you currently taking any medications? If yes, please list them below. If not, leave it blank.

Are you currently pregnant or nursing? (Certain treatments may not be recommended.)*

Do you have any known allergies to hair products or ingredients? (Yes/No)*

If YES, please list. (If NO, please list as "N/A"*

Do you have any scalp conditions or sensitivities we should be aware of? (e.g., dryness, itching, psoriasis)?*

Do you have any medical conditions or medications that might affect your hair or scalp? (e.g., hormonal treatments, thyroid conditions)*

Upload an image of hair inspiration. *

You can upload multiple files here

Upload an image of your current hair*

You can upload multiple files here

Any special instructions, comments, or suggestions?

How often do you shampoo/wash and condition your hair?*

Do you swim frequently or spend time in chlorinated pools?*

Do you use heat tools regularly?*

YesNo

When was your last haircut or trim?*

Within the past month2-3 months ago4-6 months agoOver a year ago

What is the current length of your hair?*

What is your natural curl pattern?*

Straight (1A, 1B, 1C)Wavy (2A, 2B, 2C)Curly (3A, 3B, 3C)Coily (4A, 4B, 4C)

Please indicate the list of hair products you're currently using:

What is your natural hair color?

Have you ever used box dye or at-home coloring products?

Have you ever colored your hair before?

If yes, when was your most recent color service?

What type of color service was it? (e.g., permanent, semi-permanent, highlights, balayage, etc.)

Have you received any of the following treatments in the past 12 months?

Photo Release: Do you consent to having photos of your hair taken for promotional purposes? (Yes/No)*

Service Expectations: Do you understand that results may vary depending on your hair’s condition, history, and type? (Yes/No)*

Chemical Treatments: Do you understand that chemical treatments may alter the condition of your hair? (Yes/No)*

Waiver: Do you agree to release the salon and your stylist from liability for unforeseen reactions or outcomes? (Yes/No)*

Cancellation Policy: Do you agree to our cancellation policy? Cancellations made LESS THAN 24 hours of the appointment will result in a charge of 50% of your total services.(Yes/No)*

Refund Policy: Do you agree to our refund policy? Due to the time and materials that go into your service, we do not offer refunds, however, it is extremely important to our team that you are fully satisfied with your service. In the event you are dissatisfied with the services received, our team will make complimentary adjustments within (7) days of a service, pending management approval.(Yes/No)*

DISCLOSURES & ADDITIONAL TERMS

I agree that this constitutes full disclosure, and that it supercedes any previous verbal or written disclosures.
I understand that witholding information or providing misinformation may result in contraindications and/or irritation from treatments or services received.
I am aware that it is my responsibility to inform the stylist of my current medical or health conditions, and update this history.
The services I receive here are voluntary, and I release this organization and/or stylist from any liability and assume full responsibility thereof.

UNDERAGE CLIENTS

Parental/Guardian Consent: If a client is under the legal age of 18, parental or guardian consent is MANDATORY for any service to be provided. This consent must be given in the form of a signed agreement by the parent or legal guardian, which acknowledges understanding and acceptance of the procedures and terms of service.
Verification of Consent: We reserve the right to request proof of age and verify the consent for any client who appears to be underage. This is to ensure compliance with our policies and legal obligations.
Responsibility of the Parent or Guardian: The parent or guardian who provides consent is also responsible for ensuring the underage client understands the nature of the services to be provided and agrees to the service.
Non-compliance with Age Requirement: In the event that a client has misrepresented their age or fails to provide the required parental or guardian consent if underage, we reserve the right to refuse service. Any deposits or payments made in such cases may be subject to forfeiture in accordance with our cancellation policy.

Client Signature*

Date Signed*

Date

BLUSH ARTISTRY SALON SERVICES

CLIENT INFORMATION

HEALTH & SENSITIVITIES

SERVICE GOALS

HAIR HISTORY

HAIR COLORING SERVICES ONLY

CONSENT & POLICIES