New Hair Client Intake Form

New Hair Client Intake Form

Please provide your details and hair goals to help us prepare for your visit.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What is the best way to contact you?

Other
Which hair services are you interested in? (Select all that apply)

Other
Are you interested in a “silent appointment” (no pressure for conversation)
Current hair color
Scalp allergies ? (Bleach ,hair dye, products or chemicals)
When is the last time you have had your hair colored/bleached?
Have you ever had a perm ? If yes how long ago.
Have you ever used boxed dye? If so how long ago , what color , how many times ?
What is your hair type?

Other
How often do you wash your hair?
How do you prefer your hair styled?
Do you have any concerns about your current hair? What would you change about your current hair?
What do you currently like about your hair?
Upload a current photo of the FRONT of your hair

Cancelof
Upload a current photo of the BACK of your hair

Cancelof
Upload a current photo of the SIDES of your hair

Cancelof
Upload a goal hair photo (Inspiration 1)

Cancelof
Upload a goal hair photo (Inspiration 2)

Cancelof
Preferred appointment
CLIENT DISCLOSURE & ACKNOWLEDGMENT. I acknowledge that the outcome of my hair service depends on the accuracy of the information I provide. I confirm that I fully and honestly disclosed my hair history, including prior chemical treatments, color services, and any conditions that may affect the service. I understand that failure to provide complete and accurate information may result in unintended results, I accept responsibility for the outcomes related to incomplete or inaccurate disclosure.
Thank you for completing the new client intake form please allow 24 to 48 hours for me to review your information and photos and put together a personalized plan with an estimated cost. If anything changes from what was shared in this form, the price or results may vary I will always do my best to help you look and feel your best. Thank you.

-HAIR.X.LACI
Should be Empty: