LOVE YOUR HAIR! Hair Consultation Form

First Name

Last Name

Email

Phone Number

Have you ever seen a Studio417 stylist?

YesNo

If Yes, who? (If you don't know, no problem!)

If Yes, when did you last visit the salon? (Approximate date is fine!)

What is your current hair length?

—Please choose an option—ShortMediumShoulder LengthLong

How would you describe your scalp?

—Please choose an option—DryNormalOilyScalp Issues

How would you describe the current condition of your hair?

—Please choose an option—HealthySlightly DamagedSeverely Damaged

Shampoo frequency:

—Please choose an option—DailyEvery other dayEvery few daysOnce a weekOther

How would you describe the natural texture of your hair?*

StraightWavyCurly

How would you describe the density of your hair?*

FineMediumThickSuper Thick

Are you currently taking any medication that has side effects that can cause hair thinning and/or hair loss?*

YesNo

Do you have now, or have had in the past, any problems with hair loss?*

YesNo

Do you have professional color on your hair at this time?

YesNo

Do you have unprofessional (at home) color on your hair at this time?

YesNo

When was the last time you colored your hair?

Did your last color service take place in a salon?

YesNo

Please describe your last three hair services (Ex. Haircut in April, highlight and cut in July, haircut in September)

What products are you currently using at home (shampoo, conditioner, treatments, styling products)

Please provide two current pictures of your hair.

Photo 1:

Photo 2:

Please send two to five images of a hair style you hope to achieve.

Photo 1:

Photo 2:

Photo 3:

Photo 4:

Photo 5:

Please give us more information about your hair, how you style it, what you like and dislike about your hair, and the look you want to achieve.

Select Services/Treatments:

Blowout or hair stylingHaircutColor serviceCurly hair specialistTexture or perm servicesStraightening or smoothing servicesExtensions or wig servicesEyelash extensionsMake upBrow shaping or tinting

Please select an approximate budget for your hair care needs:

—Please choose an option—less than $50 an appointmentless than $100 for an appointmentless than $150 for an appointmentless than $200 for an appointmentMy hair is my greatest accessory and I want my hair to look its best!

Please select your availability for appointments: (select all that apply)

Weekday MorningsWeekday AfternoonsWeekday EveningsWeekends