Hair Care Ritual

1
Full Name
First Name
Last Name
2
Email
example@example.com
3
Phone Number
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
In the case of an emergency, let us know who to contact
FULL NAME
RELATIONSHIP TO YOU
6
Give us the phone number of an emergency contact.
Please enter a valid phone number.
7
What are we going for today?
Please Select
Please Select
I am looking for a total change!
I love what I've got, just looking to freshen it up.
I am okay with what I've got but i feel like there is room for a slight change to make me LOVE it.
8
do you have inspo picture that you LOVE? upload them here !
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
9
if you've uploaded picture, can you tell me exactly what it is you like about the pictures?
10
how would you describe the condition of your hair?
Normal
Dry
Oily
Damaged
11
Scalp condition
Flaky
Dry
Itchy
Oily
Sensitive
Balanced
12
How often do you like to get your hair done?
Please Select
Please Select
Every week
Every 2 weeks
Every 3-4 weeks
Every 2 months
Every 2-6 months
Twice a year
Once a year
13
When is the last time you colored your hair?
Date or any approximate weeks
14
How often do you change the color of your hair?
Every month/Every 2 months/Quarterly/Yearly
15
Let's talk at home care. What does your normal hair routine look like? how often do you wash? what products?
16
Are you pregnant? (Women)
Yes
No
17
do you have any allergies? taking any medications or have any health conditions I should be aware of?
18
Tell me a bit about the history of your hair. what chemical processes have been done, when have you loved your hair? when have you hated it?
19
I am always wanting the create the environment where my clients can relax and recharge. which social style suits your mood for today?
Please Select
Please Select
I am feeling social, let's get to chatting.
I would prefer a silent appointment today.
20
I completely understand a busy schedule, do you need a work desk for your appointment today?
Please Select
Please Select
yes please, my work needs me today.
nope! This is "ME" time.
21
can we get you anything I can get you? - IF THIS CHANGES PLEASE DON'T HESITATE TO LET ME KNOW
Please Select
Please Select
I am all good.
I'd like something to drink
I'd love a snack.
I would like a snack and a drink.
I am in need of a phone charger.
22
Is there a budget you'd like me to be respectful of for your hair today?
23
Is there a time you need to be finished by today?
24
Is there anything I should know before we get started? tender scalp, hair knots easily, hair loss, trying to grow it out ect.
25
To make sure that you are leaving the salon with all expectations met, is there anything that you want to AVOID today?
26
Terms and Conditions* This field is required.
27
Date Signed
Date
Month
Day
Year
28
Client's Signature
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