Client Intake Form

Client Intake Form

Hello! My name is Mariah Brasel and I am the owner of Hair By Mariah Brasel. I am so excited to be apart of your extension journey. The first step in that journey if for us to get to know each other a little better. The more information I have about you - your lifestyle, scalp health, home care routine, hair goals, etc. - the better I will be able to meet (and exceed!) your expectations. The more you know about my process - onboarding, policies, expectations- the less overwhelming (and stressful!) the consultation will be. This process should take about 20 minutes in total - so be sure that you have dedicated time to dive in before starting. I always strive to make working with me low pressure - so if you need to come back at a later time please don't feel pressured to get started right away. After all, getting your hair done should be a pleasant experience! Paper work might not be, but I promise to keep it at a minimum.
Your name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How would you like to be contacted?
Are you wearing extensions currently?
How many rows are you wearing (or if not wearing any currently - how many rows did you wear previously? If you've worn different amounts of rows go with the option you wore for the longest period of time).
What has your experience with extensions been like? Have you had a bad experience? If so, can you describe why it was negative? If the experience(s) were positive would you please detail what you enjoyed?
*If you have not had extensions please write N/A in box above.
Extensions are a luxury investment - what is your beauty budget so that I can recommend the best customized solution for you?
Extensions require frequent maintenance - how often are you comfortable coming in?
Extensions are a very detailed service - how much time are you comfortable spending in the salon for maintenance appointments?
Your at-home routine will change with extensions - how much time are you willing to dedicate to caring for them?
To love your extensions, you also need to love your hair color! What best represents how you feel about your color currently?
Please upload 3 images of your current hair: 1 from the front - (please include your face), 1 from the side, 1 from the back. Enlisting a helper is recommended for the back of the head photo. These photos must be taken in indirect light (think of in your house near a window, but without the rays hitting you). Please do not send old photos, photos with filters/editing, or photos in direct sun or in fluorescent/bathroom lighting.

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Please upload a picture of your dream hair.

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How often do you wear your hair up in a ponytail/bun/braid/upstyle?
How often do you wash your hair?
Does your scalp get irritated?
Have you ever suffered from dandruff, eczema, folliculitis, or psoriasis? If so, please list everything that applies. Please also detail when these issues occurred (or if they are current).
*If you haven't had any of these issues please type "N/A" in box above.
Have you noticed any change in the density of your hair or the amount of hair you are shedding? If so please list when these changes started and if they are ongoing or have stopped.
*If you haven't had any of these issues please type "N/A" in box above.
How did you hear about me?
If referred by someone in specific please list their name below:
Is there anything you want to share with me that we did not cover?
Should be Empty: