Client Intake Form

Client Intake Form

Dear client,

our sincerest hope is to serve you with the best hair care services you’ve every received! We not only want you to be happy with today’s visit, we also want to build a long-lasting relationship with you, the client.

In order for us to do so, we would like to learn more about you, your hair care needs and your preferences Please take a moment now to answer the questions below as completely and as accurately as possible.

Thank you, and we look forward to building a “beautiful” relationship!

Name:_______________________________________________________________________

Address:_____________________________________________________________________

Phone Number: (Day)_______________(Evening)________________(Cell)________________

Email Address:________________________________________________________________

Sex: _____ Male ______ Female _____Age

How did you hear about our salon?________________________________________________

If you were referred, who referred you? ____________________________________________

Please answer the following questions in the space provided. Thanks!

Approximately when was your last salon visit?_____________________________________

In the past year have you had any of the following services either in or out of a salon?

_____ Haircut _____ Manicure

_____ Haircolourv _____ Artificial nail services

_____ Permanent Wave or Texturizing Treatment _____ Pedicure

_____ Chemical Relaxing or Straightening Treatment _____ Facial/ Skin Treatment

_____ Highlighting or Low lighting _____ Other

_____ Full head Lightening

What are your expectations for your hair service(s) today?__________________________________________________________________________

Are you now or have ever been...