Questionnaire

Client’s Name

First NameLast Name

Client's Phone Number

Area CodePhone Number

Client's Email Address

example@example.com

Occupation

Date of Birth

Date

What’s your hair inspiration?

A famous person or simply “good condition”

If you’d like to, please upload an image of hair you like

Browse Files

You can upload multiple files here

Tell me something about your hair

Is it long, fine, thick, damaged, curly? Etc

To help me prepare for your appointment, and also record your hair journey, please upload an image of your current hair.

Browse Files

You can upload multiple files here

Do you ever treat your hair with a “mask” or similar, if so how often?

How long is your hair?

Medium is on or around your shoulders

How often do you shampoo and condition your hair?

What is the current condition of your hair?

Have any of these been used in your hair before?

When did you last visit a hair salon?

Date

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

Are you currently taking any medications? If yes, please list below. If not, please leave blank.

What hair products are you currently using?

Are you interested in using professional hair care products at home if you don’t already?

Other

How did you hear about me?

Any special instructions, comments, or suggestions?

Client Signature

Date Signed

Date