Clone of SLT Pre-Consultation Questionnaire

1
Client Name * This field is required.
First Name
Last Name
2
Assessment Date * This field is required.
Date
Year
Month
Day
3
Assigned Stylist* This field is required.
Lucy S
Sharona L
D Chante
Natasha W
4
Assigned Stylist Mobile Number* This field is required.
5
Assigned Stylist Email
example@example.com
6
Consultation Service Type* This field is required.
Microlock / Sisterlocks™ Installation
Loc Extensions / SolarLoc™ Custom Plan
Braid Takedown / Loc Comb-Out Removal
Continuous Care / Maintenance & Repair
Other
7
01. Current Hair Length?* This field is required.
< 4"
4"–8"
8"–12"
12"–16"
16"–24"
24"+
8
02. Loc / Braid Age?* This field is required.
N/A (Loose Hair)
< 1 Year
1–3 Years
3–5 Years
5+ Years
9
03. Chemical History (Last 12 mos)?
None
Color/Lightener
Relaxer/Perm
Keratin/Texturizer
10
04. Did you notice any Visible Thinning / Low Density?* This field is required.
No
Yes – Isolated to the Crown
Yes – Isolated to the Edges
Yes – Isolated to the Nape
Yes – Active All Over (Generalized Thinning)
11
05. Did you observe signs of Traction Alopecia?* This field is required.
No
Yes – Present at the Temples
Yes – Present along the Hairline
Yes – Present around the Perimeter
12
06. Did you identify any Weak Spots or Structural Breakage?* This field is required.
No
Yes – Present at the Mid-Shaft
Yes – Present near the Root / New Growth Base
Yes – Present near the Ends
13
07. Did you detect Excessive Buildup, Lint, or Product Retention?* This field is required.
No
Yes – Surface level product residue
Yes – Embedded lint / environmental debris
Yes – Internalized debris within the loc core
14
08. How would you rate the client's Matting Severity?* This field is required.
None (Loose / Clear hair sections)
Mild (Standard web-like tangling easily softened)
Moderate (Compacted tangling requiring extensive manual pin work)
Severe – Solid Mass (Interlocked matting at risk of structural loss)
15
09. Did you observe any Scalp Irritation or Active Conditions?* This field is required.
No Active Irritation Verified
Yes – Dryness / Severe Flaking / Pityriasis
Yes – Erythema / Redness & Inflammation
Yes – Open Lesions / Sores / Excoriation
16
01. 📷 Front View / Frontal Hairline* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
17
02. 📷 Top View / Crown* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
18
03. 📷 Back View / Nape* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
19
04. 📷 Left Side View / Edges* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
20
05. 📷 Right Side View / Edges* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
21
01. Identified Risk Factors?* This field is required.
Locs over 5 years old
Severe chemical/lightener damage
Medical hair loss / Alopecia diagnosis
Extremely fine / fragile hair diameter
Pre-existing structural breakage at root
Severe matting / interlocked buildup
Out-of-scope foundation profile (Two-strand twist history / Unmanaged medical scalp condition)
There was not any identified risk factors
22
02. Overall Risk Level Rating* This field is required.
Low Risk: Hair integrity is healthy; proceed with standard service protocol.
Moderate Risk: Pre-existing weakness/history identified; service modification or home-care prep required.
High Risk: Significant structural or operational risk; high potential for damage, or service falls outside studio criteria
23
Did you observe, or did the potential client explicitly state, any of the following parameters regarding their hair or scalp journey?* This field is required.
PAIN_HISTORY: Client is seeking a new stylist due to consistent scalp discomfort or pain experienced during past maintenance sessions.
PAIN_HISTORY: Client is seeking a new stylist due to consistent scalp discomfort or pain experienced during past maintenance sessions.
BRAID_FOUNDATION: Client's loc transition began using a braid-in technique, and they are seeking specialized maintenance for this texture foundation.
TWIST_FOUNDATION: Client's locs were established using a two-strand twist technique, and they are interested in exploring a new or altered loc style.
UNMANAGED_SCALP: Client is currently managing a dynamic scalp condition and has not yet had it evaluated by a medical professional or dermatologist
None of the above statements were applicable to the client
24
01. Stylist Clinical Observations & Detailed Findings * This field is required.
Huge
Large
Normal
Small
Ok
Ok
25
01. Action Recommendation?* This field is required.
PROCEED
MODIFY SERVICE
DECLINE SERVICE / REFUSAL
26
02. Explanation Category
PROCEED - Healthy Canvas: Scalp is clear, and hair density, elasticity, and tensile strength are excellent.
PROCEED - Mature Loc Baseline Verified: (For transfer clients) Grid lock structure, root torque, and interlocking patterns are stable and ready for maintenance.
PROCEED - Ideal Texture for Extensions: Natural hair possesses optimal curl pattern and sufficient length to seamlessly anchor SolarLoc extensions.
MODIFY - High-Risk Boundary Prep Required: Perimeter/edges show mild stress; requires larger grid grouping, reduced tension, or oil-elixir pre-treatment.
MODIFY - Test Lock Mandatory: Fine or highly slippery hair texture; requires a 2-week test lock observation phase before full installation commitment.
MODIFY - Size / Count Adjustment Required: High density or structural fine-ness requires shifting from the client's requested sizing to a technically stable micro/small balance grid.
MODIFY - Pre-Service Detox Required: Severe product/lint buildup detected; requires a deep clarifying/ACV detox session before technical lock validation can proceed.
DECLINE - Hair integrity at unacceptable risk of severe breakage.
DECLINE - Active scalp inflammation/infection requiring medical evaluation.
DECLINE - Unrealistic expectations regarding outcome/density.
DECLINE - Out-of-Scope Service Criteria (Two-Strand Twist / Non-Standard Base).
27
Detailed Explanation & Recommended Next Steps* This field is required.Detailed Explanation & Recommended Next Steps / Referrals
Huge
Large
Normal
Small
Ok
Ok
28
Assessing Stylist Signature
29
Senior Stylist / Owner Review Review Date
Date
Year
Month
Day
30
Review Status* This field is required.
Approved
Overridden
Should be Empty: