New Salon Client Intake Form
Let’s get personal (with your hair of course)!
Hello there 🙋🏻♀️ I’m so happy you’re here!
Full Name 🤗
*
First Name
Last Name
Age (optional!)
Date of Birth (optional! Share for birthday treats) 🎂
-
Month
-
Day
Year
Email Address
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address (Optional! For holiday cards and sweet surprises!) 📬
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your preferred method to reach you? 📞📧
What type of service are you looking for? 💇🏻♀️
Share with me what your hair goals are? 💛
What do you love and not love about your hair?
Upload a few photos of your current hair, this gives me a better idea of where we’re starting 💁🏼♀️
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload a few inspiration photos, if you have them! These help me understand your hair goals 🥳
Browse Files
Drag and drop files here
Choose a file
Cancel
of
When are you looking to make an appointment? 🗓️
Anything else you’d like to share with me ☺️
How did you hear about me?
Facebook
Instagram
Online Advertisement
Google Search
Referred by a friend
Other
Would you like to receive updates and specials from Michelle Perone Hair via email? 📩
Yes
No
Date
-
Month
-
Day
Year
Please verify that you are human
*
Print Form
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