Please Wait...

Hair Salon Client Intake -Form Fill

Q1

First Name

Client's Name
Q2

Last Name

Client's Name
Q3

Date of Birth

Date of Birth
Q4

Phone Number

Client's Phone Number
Q5

Client's Email Address
Q6

Occupation
Q7

Select a hair service
Q8

What hair style do you like?
Q9

Upload an image of hair style or hair color you prefer
Q10

Upload an image of your current hair
Q11

How often do you go to salon for hair treatment?
Q12

How long is your hair?
Q13

What is the current condition of your hair?
Q14

What is the condition of your scalp?
Q15

How often do you apply shampoo and conditioner in your hair?
Q16

Have you use the following in your hair before?
Q17

When did you last visit a hair salon?
Q18

When did you last visit a hair salon?
Q19

When did you last apply professional or unprofessional color in your hair?
Q20

How did you hear about us?
Q21

Any special instructions, comments, or suggestions?
Q22

Client's Signature
Q23

Date Signed