Please Wait...

Hair Consultation -Form Fill

Q1

Select a hair service
Q2

First Name

Client's Name
Q3

Last Name

Client's Name
Q4

Phone Number

Client's Phone Number
Q5

Client's Email Address
Q6

Occupation
Q7

Date of Birth
Q8

What hair style do you like?
Q9

Upload an image of hair you prefer
Q10

Tell us something about your hair
Q11

Upload an image of your current hair
Q12

How often do you go to salon for hair treatment?
Q13

How long is your hair?
Q14

Kindly describe the status of your scalp.
Q15

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

What is the current condition of your hair?
Q17

Have you use the following in your hair before?
Q18

When did you last visit a hair salon?

Date
Q19

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

Do you have any hair loss problems in the past?
Q21

How did you hear about us?
Q22

Any special instructions, comments, or suggestions?
Q23

Client Signature
Q24

Date Signed