The Beauty Bar Expo
Client Intake Form
Welcome
Thank you for choosing The Beauty Bar Expo. Please complete this form prior to securing your appointment so I can be sure to provide a safe, comfortable, and personalized experience
CLIENT INFORMATION
Name
*
First Name
Last Name
Caregiver/Contact Name (if applicable)
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email (optional)
example@example.com
Service Address (where appointment will take place)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
HEALTH & SAFETY
Does the client have any allergies? (products, scents, latex, etc.)
*
Are there any scalp conditions or sensitivities I should be aware of?
*
Mobility Level
*
Bedridden
Wheelchair
Limited mobility
Requires assistance
Other
Is the client experiencing any pain or areas that should be avoided during the service?
*
Is there anything I should know to ensure a safe and comfortable experience?
*
SERVICE DETAILS
Requested Service
Please Select
Shampoo
Styling
Straightening
Braids
Others
Current Hair Condition
*
Normal
Tangled
Severely matted
Hair Length
Short
Medium
Long
Appointment Request (1st option)
Please select best day and time frame for services
Monday 9am-11am
Monday 12pm-3pm
Tuesday 9am-11am
Tuesday 12pm-3pm
Wednesday 9am-11am
Wednesday 12pm-3pm
Other
SERVICE PREPARATION
Is the home smoke-free?
*
Yes
No
Will there be a clean, safe space available to perform the service?
*
Yes
No
Will the client be ready at the scheduled appointment time?
*
Yes
No
BOOKING AGREEMENT
Please review and acknowledge the following:
*
I understand a $50 Non-refundable deposit is required to secure my appointment
I understand cancellation require at least 24-hour notice
I understand deposits are forfeited for no-shows or late cancellations
I understand pricing may vary based on hair condition and time required
I agree to provide a clean, safe, and smoke-free environment
PHOTO CONSENT (OPTIONAL)
Photo Release Consent
I give permission for photos to be taken
I give permission for photos to be taken (no face shown)
I do NOT give permission
SIGNATURE
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: