New Client Consultation Form
Select the hair service of your interest. Please note that some options are not yet available.
Adult Hair Cut
Kid Hair Cut
Hair Treatment
Hair Color (Permanent)
Hair Color (Semi)
Braids
Hair Styling
Highlights
Silk Press
Kid Silk Press
Twists
Other
Select an appointment day of your interest.
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Client's Name
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First Name
Last Name
Client's Phone Number
*
Format: (000) 000-0000.
Client's Email Address
*
example@gmail.com
What is your gender?
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Male
Female
Perfer not to say
Occupation? ex: fitness trainer
*
(This is to get a scope of what your hair goes through on a daily basis)
Date of Birth
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-
Month
-
Day
Year
(For your profile and future birthday specials)
Upload an image of your dream hairstyle.
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Browse Files
Drag and drop files here
Choose a file
Cancel
of
Tell me your hair concerns. What are some things you like and don't like about your hair?
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Upload an image of your hair's current state.
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Browse Files
Drag and drop files here
Choose a file
You can upload multiple files here. Don't worry your uploads will only be kept in your files.
Cancel
of
When was your last salon visit?
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Month
-
Day
Year
How often do you go to the salon?
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Every two weeks
Once a month
Every two months
Every 3-6 months
Once a year
Twice a year
Never
What is your hair length?
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Please Select
Short
Medium
Long
Kindly select the status of your scalp.
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Please Select
Dry
Normal
Oily
How often do you shampoo and condition your hair?
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Every day
Every other day
Once a week
Twice a week
Every two weeks
Once a month
What is the current condition of your hair? Check all that apply.
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Hair loss
Heat damage
Split ends
Breakage
Itchy scalp
Dry hair
Dandruff
Oily hair
Water resistant
Other
Have you gotten or used the following chemicals in your hair before?
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Permanent hair color
Keratin Treatment
Relaxer (to remove curly texture)
Henna
Perm (to add curly texture)
Box dye
None
Other
When and what was the last application of professional or unprofessional chemicals in your hair? If you haven't, please leave it blank.
Do you have or have had any hair loss problems in the past? Causes? If you haven't please leave it blank.
Do you have any allergies? If yes, please list them below. If not, leave it blank.
Please indicate a list of hair products you're currently using:
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How did you hear about us?
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Facebook
Instagram
Online Advertisement
Referred by a friend
Tiktok
Other
Any special preferences, comments, or suggestions?
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