CLIENT QUESTIONNAIRE FORM
Name
Email Address
Phone
Anything you’d like to change about your hair? (select all that apply)
Hair Cut
Hair Color
Hair Style
Length
Too Straight
Too Curly
Condition/Dry
What motivated you to visit The Salon?
Select ...
Hair Emergency
Need a Change
Special Occasion
Referral
Other
Chemical History: (select all that apply)
Professional Salon Color
At Home Box Color
Highlights
Lightener/Bleach
Permanent Wave
Relaxer/Keratin Straightener
None of the Above
What hair or scalp products are you currently using?
Life Style Info: to help your stylist perform service(s). (select all that apply)
Swimmer
Over-the-counter or prescription meds
Recent Surgery
Pregnant
Well Water
None of the Above
I consider my overall hair texture to be (select one)
Select ...
Fine / Thin
Medium / Average
Coarse / Thick
My current hair length (select one)
Select ...
Short / Above the Jaw
Medium / Above the Shoulder
Long / Shoulder
Extra Long / Between Shoulder Blades
Thank you! Your submission has been received!
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