First Service Consultation Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Area Code
Phone Number
4
City, State* This field is required.
5
How would you like to be contacted* This field is required.Please select one
Email
Call
Text
6
How'd you find Jean Is Hair?* This field is required.
Instagram
Google
Prodcut Line
Walking or Driving
Local Business
Met in Person
Referral by Friend
Facebook
7
What's the name of your friend who referred you?* This field is required.
8
Are you looking for services specifically tailored for curly hair?
Yes
No
Other
9
Are you looking for color, cutting services or both?If both, select both.
Color
Haircut
Other
10
Check off all of the services you think you might need.* This field is required.
Grey Coverage
Balayage
Highlights
Haircut
Clipper Cut
Color Correction
Lowlights
Conditioning Treatment
Product Recommendations
Toner
Styling Lessons
Blow-Dry
Protein Treatment
Other
11
To provide you with the best service, I kindly request that you upload 3 photos: two showing the front and back of your current hair and one inspiration image of your desired look. Rest assured, there will be no judgment.
12
Please upload one clear picture of the back of your hair* This field is required.
13
Please upload one clear picture of the front of your hair* This field is required.
14
Please upload one inspiration picture of your desired look* This field is required.
15
Hair Density ExamplesPlease click “NEXT” after you are done
16
How would you describe your hair density/thickness?* This field is required.Please scroll down for all options
Extra Light
Light
Light - Medium
Medium
Medium Heavy
Heavy
Extra Heavy
17
Hair Length ChartPlease click “NEXT” after done
18
In the state that you wear it most often (Natural, Straightened, Smoothed, Curly etc.), How would you describe your hair length?* This field is required.Please scroll down for all options
Short
Medium
Long
Extra Long
19
Your hair history within the last 3+ years.* This field is required.
I have colored my own hair.
I have not colored my hair in 3+ years.
I have gotten my hair colored professionally.
Other
20
What hair color/product did you use? Please Check all that apply.* This field is required.
From Sally's Beauty Supply
From A Salon
From Drugstore/Grocery Store
Box Dye
Temporary Hair Color Rinse
From Online
Other
21
Do you currently have any scalp or hair issues of which you are aware? (check all that apply.)* This field is required.
Thinning
Bald Spots
Irritation
Flaking
Oily Roots
Dry Ends
Hair Breakage
None of the above
22
Is there anything else you'd like to share?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
23

When I receive your form, I will respond within 24 hours of my scheduled work days, which are:

Tuesday 10am - 8pm

Thursday 10am - 8pm

Friday 10am - 7pm

Saturday 9am - 5pm

Please note a credit card will be required and authorized for all appointments. I have a firm 24-hour cancellation and/or rescheduling policy for every client. If you cancel in less than 24 hours of your confirmed appointment or are a “no call, no show,” a 100% scheduled service fee will automatically be charged to your credit card I have on file. Thank you for your understanding.

If you have any questions as you complete this form, please contact me via email at jean@jeanishair.com or text me at 617-957-1932.

I look forward to meeting you!

Jean Marie Flaherty
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