Client Intake Form

The Girl Who Does My Hair

New Client Intake Form
Client's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Client's Phone Number
Format: (000) 000-0000.
Client's Email Address
example@example.com
Select a hair service

Full Custom ColorColor MeltPartial Custom ColorGrey CoverageFace Frame Custom ColorAll Over ColorGlossHaircut
Upload an image of any INSPIRATION pictures you may have here. Feel free to browse my Instagram and use those.

You can upload multiple files here
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Upload an image of your current hair. Please upload from multiple angles.

You can upload multiple files here
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How often do you go to salon for hair treatment?

Every weekEvery 2 weeksEvery 3-4 weeksEvery 2 monthsEvery 2-6 monthsTwice a yearOnce a yearOther
How long is your hair?

ShortMediumLongOther
What is the current condition of your hair?

Hair lossDamage due to heatSplit endsBreakageItchy scalpHair is dryDandruffOther
What is the condition of your scalp?

DryNormalOilyOther
How often do you wash your hair?

Every dayEvery other dayTwice a weekOnce a weekOther
Have you ever used the following in your hair before?

Permanent hair colorKeratin TreatmentRazor cut/ThinningRelaxerHenna
Anything else you would like me to know about your hair currently/hair goals?
Kindly list the hair products that you are using
What are the tools you are using to style your hair?
How did you hear about me?

InstagramTik TokOnline AdvertisementReferred by a friendOther
By signing below, I agree to the terms and conditions the Salena is only taking a few new clients at this time and I may not be able to get in as soon as I would like to. I also understand that we may not be the right fit and she will try her best to send me in the right direction to find the stylist I need if that is the case.
Client's Signature
Date Signed

MonthDayYear
Date
Should be Empty:

The Girl Who Does My Hair