New Client Profile

1
Full Name* Este campo es obligatorio.
First
Last
2
Preferred NameOptional
3
PronounsOptional
4
There are sometimes factors which can alter the desired outcome of your hair color such as using at-home (box color) hair color, pre/post pregnancy hormones, breastfeeding, usage of recreational/medicinal marijuana, hormone therapy, autoimmune and controlled substance prescriptions, etc.

Notifying me of any of these examples to schedule a test strand consultation will allow me to adjust the hair color formulas accordingly, to avoid any less-than-favorable results. However, I will not be able to guarantee rendered chemical services, due to the unpredictable and inconsistent outcomes they create.

The health and integrity of your hair is my top priority. The Test Hair Strand will reveal if your hair will create any adverse reactions, compromise your hair or will not lift/lighten to your desired result.

Proceeding, we will discuss your options that are available to be received.
5
Have you used at home hair color (box color) within the last 5 years?* Este campo es obligatorio.
NO
YES
6
Are you currently pregnant, trying to become pregnant or postpartum?* Este campo es obligatorio.
NO
YES
7
If yes, are you currently breastfeeding?* Este campo es obligatorio.
NO
YES
8
Are you being prescribed usage of medicinal or recreational marijuana, controlled substances, autoimmune or hormone therapy, by your physician?* Este campo es obligatorio.
NO
YES
9
Have you experienced alopecia in the last 5 years?* Este campo es obligatorio.Androgenic, Areata, Totalis, Universalis, Cicatricial, Postparum or Traction Alopecia
NO
YES
10
After Care

Shampooing with non-professional at-home care and/or rinsing with hot/warm water greatly reduces the vibrancy, shine of your rendered services and will effect the outcome of its longevity. It is best to wait until 48 hours, utilizing cooler water and professional hair care after your experiences.
11
Informed Consent, Policies and Guidelines
12
Please read carefully before proceeding.

1. By completing this form, I understand to proceed with my appointment of the services that are recommended to me, I will be required to leave a credit card on file, to hold my reservation.

2. I understand, any corrective adjustments must be brought to Diana's attention within 7 days of my visit and the follow-up appointment will take place within 14 days of original reservation, pending on her availability. All adjustments will specifically be addressed based off what was originally noted and discussed in this form, The 5 C's consultation: Condition, Cut, Color, Cost and Convenience. I understand that additional changes that were not discussed in original consultation will require a second reservation with reflecting investment.

3. I understand that guest reservations are made as efficiently as possible. Tardiness up to 10-minutes may not receive all services and experiences requested, without changes reflecting in my investment. A tardiness up to 15-minutes will be considered a late cancellation. Any late cancellation (within 48-hours prior to reservation) will receive a rebooking fee of 50% of services total.

4. To cancel an appointment, I will inform Diana 48-hours prior to my appointment. I understand cancellations within 48-hours of scheduled reservation will be charged a 50% of services reserved.

5. I understand, that failure to give any notice for a missed reservation will result in a rebooking fee for the full experiences reserved. To inquire for a new reservation time, I will be only allowed to call ahead and request for a same day reservation, if available.
13
6. I understand to arrive with my hair in its natural state, shampooed and dry within 3 days of my reservation for all services and experiences requested.

7. If I am receiving any Elevated Curl Cut experiences, I will arrive with my natural curls dry with light-hold styling products, down, unaltered by hats, ponytails, clips, buns and other syles. Arriving with my curls otherwise will result being rescheduled, receiving a rebooking fee of 50% of services and experiences reserved.

8. I understand if I have product build-up, from the long or short term usage of raw oils and butters in my home care regiment, the damage cannot be completely amended within first 6 months of consistent maintenance reservations.

9. If I am receiving any chemical services, major or minor changes will be based off what the integrity of my hair allows. I will not request for my hair to be compromised to achieve a requested result.

10. I understand the investment of receiving any services and experiences, are based off the amount of hair-coloring product utilized; density, length and texture; and time require to achieve my desired result.

11. I understand to arrive without additional guests or children, for liability and quality of my experience.

12. All reservations are by appointment only.
14
I have read, understood and completed this questionnaire truthfully. I understand all policies and guidlines.* Este campo es obligatorio.
I agree
15
I grant permission to Nomad Hair Co to use my photos and all forms of media for marketing, promotional literature, educational and social media purposes.
I grant permission.
16
Date* Este campo es obligatorio.
Date
Month
Day
Year
17
Signature* Este campo es obligatorio.
Should be Empty: