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Toggle Navigation
HOME
ABOUT ME
HAIR
What’s New
Keratherapy treatment
Brazilian Blowout EXPRESS
Hair Extensions
Client Information Form
MAKEUP
BRIDAL
Bridal Services Contract
SHOP
Face
Eyes
Lips
Brushes
CONTACT
Menu of Services
Client Information Form
Client Information Form
superadmin
2023-06-03T14:41:59+00:00
Hair Enhancement Client Information
Name
Email
Phone number
What is the current length of your hair?
Long
short
shoulder length
What is your desired length?
Long
short
shoulder length
Do you have any prior color (professional/box) currently in your hair?
Yes
No
How is your scalp?
oily
dry
flakey
sensitive
Have you had hair extensions before?
Yes
No
Do you have a medical condition wherein hair loss is present like alopecia?
Yes
No
Are you currently in treatment for hair loss?
Yes
No
Are you currently taking medication for hair loss?
Yes
No
Do you have any skin-related disease?
Yes
No
If yes, please explain
Do you have any allergies?
Yes
No
If yes, please explain
Are you sensitive to metals?
Yes
No
If yes, please explain
Do you regularly swim?
Yes
No
Have you been pregnant in the last 6 months?
Yes
No
If yes, please explain
Do you usually workout?
Yes
No
Consent
(Required)
I confirm that all information I entered in this form is accurate and true.
(Required)
Consent
(Required)
I agree and confit after discussing with Angie that w picked the best method(s) that work with my lifestyle and maintenance schedule.
(Required)
Consent
(Required)
I understand that I need to follow pre-procedure and post-procedure care.
(Required)
Consent
(Required)
I understand that for canceling or rescheduling, I need to call the salon or clinic directly and talk to the staff to get voice confirmation.
(Required)
Consent
(Required)
I confirm that the salon does not provide a refund for deposit payments.
(Required)
Consent
(Required)
I released the salon for any liabilities or hold harmless for any damages, injury, or accidents that can happen during or after the procedure.
(Required)
Consent
(Required)
I understand that because of the hairs natural growth cycle i will need to book and attend maintenance appointment every 4 to 6 weeks in order for my service to be guaranteed.
(Required)
Consent
(Required)
I understand that removal must be performed by a hair salon technician or extensionist. By signing below, you agreed that you have read and understood the terms and agreement above.
(Required)
Sign
(Required)
Date
(Required)
MM slash DD slash YYYY
Client information Form
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