Soleil Blanc Salon

Soleil Blanc Salon

New Guest Intake Form
Soleil Blanc Salon, LLC

Brigitte Polyack, owner & stylist

2102 Greentree Road, Suite B201, Pittsburgh, PA 15220

(833) 909-5898
Name

First NameLast Name
Email
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Phone Number
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Describe what you'd like to achieve today.
What services are you considering for the future?
What shampoo & conditioner are you using at home?
What styling products are you using at home?
Check all that apply: What are some of your primary hair concerns:
Have you ever experienced irritation, a rash, itching, or burning, or hives from hair color, highlights, or color remover?
If yes, please explain what happened.
Have you ever had a haircut you weren't happy with?
Have you ever had a color or highlight service you weren't happy with?
What inspired you to change hairdressers?
How often do you prefer to come into the salon?
Have you ever colored your hair at home?
In the past six (6) months have you used hair regrowth serums:

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