NicoleStoverHair.com

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NicoleStoverHair.com

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NicoleStoverHair.com

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New Client Consultation Form
Select a hair service

Adult Hair Cut Kid Hair Cut Cut & Shampoo Hair color (Permanent) Hair color (Semi) Hair Color Blending Hair Conditioning Hair styling (Formal) Hair styling (Special Occasion) Perms Relaxers Retexturizing Highlights Other
Client's Name

First Name Last Name
Client's Phone Number
Client's Email Address
example@example.com
Date of Birth

Month Day Year
Date
What hair style do you like?
Upload an image of hair you prefer

You can upload multiple files here
Cancel of
Tell us something about your hair
Upload an image of your current hair

You can upload multiple files here
Cancel of
How often do you go to salon for hair treatment?

Every week Every 2 weeks Every 3-4 weeks Every 2 months Every 2-6 months Twice a year Once a year Other
How long is your hair?
Kindly describe the status of your scalp.
How often do you apply shampoo and conditioner in your hair?

Every day Every other day Twice a week Once a week Other
What is the current condition of your hair?

Hair loss Damage due to heat Split ends Breakage Itchy scalp Hair is dry Dandruff Other
Have you use the following in your hair before?

Permanent hair color Keratin Treatment Razor cut/Thinning Relaxer Henna
When did you last visit a hair salon?

Month Day Year
Date
When did you last apply professional or unprofessional color in your hair?
Do you have any hair loss problems in the past?
Please indicate the list of hair products you're currently using:
How did you hear about us?

Facebook Twitter Instagram YouTube Online Advertisement Google Search Referred by a friend Newspaper/Magazine Other
Any special instructions, comments, or suggestions?
Client Signature

Clear
Date Signed

Month Day Year
Date
Should be Empty:

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Home/
About Me/
New Guests/
Menu/
Booking/
Work Creations/
Ouidad/
Transformations/
Wedding Portfolio/
Client Reviews/
Policies/
Contact/

NicoleStoverHair.com

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New Guests

NicoleStoverHair.com

New Client Consultation Form

NicoleStoverHair.com