Please Wait...

Salon Consultation -Form Fill

Section One
Q1

Name

First Name

Q2

Name

Last Name

Q3

Phone Number

Area Code

Q4

Phone Number

Phone Number

Q5

Email

Q6

Select a salon service

Q7

What hair style do you like?

Q8

Upload an image of the hair style you prefer

Q9

Any special instructions?

Q10

How often do you go to salon?

Q11

How long is your hair?

Q12

How often do you apply shampoo in your hair?

Q13

Kindly describe the status of your scalp.

Q14

Describe your hair by checking the options below: (You can select more than one)

Q15

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

Q16

Do you have any hair loss problems in the past?

Q17

Are you currently taking any medications? If yes, please list them below. If not, please put N/A.

Q18

Please indicate the list of hair products you're currently using:

Q19

How did you hear about this salon?

Q20

Client Signature

Q21

Date Signed

Date