New Client Form
This will help us prepare to give you the best results from your service.
Full Name
*
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Phone Number
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred method of contact:
*
i.e Phone, email, text
When is the best time to reach you?
Hair texture, length, and density
*
i.e. Curly, wavy, straight / long, short, mid length / thick, thin, medium
Could you tell me a little about how you style your hair?
*
How long does it take? Always natural or heat styled? etc.
What are three things that you love about your hair?
*
What are the things you don't like about your hair?
*
What products are you using on your hair?
How did you hear about us?
Facebook
Twitter
Instagram
Online Advertisement
Google Search
Referred by a friend
Other
Would you like to receive updates from me via email?
*
Yes
No
Date Signed
*
-
Month
-
Day
Year
Date
Client's Signature
*
Print Form
Submit
Submit
Should be Empty: