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Hair Color Consultation -Form Fill

Q1

First Name

Full Name
Q2

Last Name

Full Name
Q3

Email
Q4

Phone Number

Phone Number
Q5

Street Address

Address
Q6

Street Address Line 2

Address
Q7

City

Address
Q8

State / Province

Address
Q9

Postal / Zip Code

Address
Q10

Type of Hair Color Service
Q11

Preferred Stylist
Q12

Desired color
Q13

Type of Hair
Q14

Current length of Hair
Q15

Hair Condition
Q16

Scalp condition
Q17

Where did you hear about this salon?
Q18

How often do you go to salon?
Q19

When is the last time you visited a salon?
Q20

How often do you change the color of your hair?
Q21

Have you used a permanent color before?
Q22

Have you used a semi-permanent color before?
Q23

Do you wear a wig?
Q24

Do you have any synthetic hair?
Q25

What shampoo and conditioner are you using?
Q26

Are you pregnant? (Women)
Q27

Any special instructions?
Q28

Date Signed
Q29

Client's Signature