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NEW CLIENT FORM
WELCOME TO GEGE SALON
FIRST NAME
*
LAST NAME
*
EMAIL
*
PHONE
*
WHAT ARE YOUR HAIR GOALS?
*
UPLOAD AN INSPIRATION PHOTO
*
Upload File
UPLOAD YOUR CURRENT HAIR
*
Upload File
HOW OFTEN DO YOU GO TO THE SALON FOR HAIR TREATMENTS?
*
Every week
Every 2 weeks
Just for a relaxer, keratin, cut or color
Special occasions
Other
IF "OTHER" PLEASE EXPLAIN:
WHAT LENGTH IS YOUR HAIR?
*
Short (above shoulder)
Medium (up to top of shoulders)
Long (below shoulder)
Very long (waist and below)
Other
WHAT IS THE CURRENT CONDITION OF YOUR HAIR?
*
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Dry hair
Dandruff
Other
WHAT IS THE CONDITION OF YOUR SCALP?
*
Dry
Normal
Oily
Other
HOW OFTEN DO YOU APPLY SHAMPOO AND CONDITION TO YOUR HAIR?
*
Every day
Twice a wee
Once a week
Every other week
Other
HAVE YOU EVER USED THE FOLLOWING IN YOUR HAIR BEFORE?
*
Permanent hair color
Keratin treatment
Bleach
Relaxer
Henna
WHEN DID YOU LAST WEAR BRAIDS/EXTENSIONS?
WHEN DID YOU LAST APPLY PROFESSIONAL OR UNPROFESSIONAL COLOR IN YOUR HAIR?
ARE YOU TAKING ANY MEDICATIONS?
*
Yes
No
IF YES, LIST MEDICATION AND PURPOSE
WHAT PRODUCTS ARE YOU USING AT HOME?
*
HOW DID YOU HEAR ABOUT SALON GEGE ?
*
Facebook
Twitter
Instagram
Youtube
Google search
Referred by a friend
Other
ANY SPECIAL INSTRUCTIONS, COMMENTS, EXPECTATIONS OR SUGGESTIONS?
*
I confirm that all information indicated in this form is true and accurate.
*
Yes
No
Signature
*
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Date
*
Month
Day
Year
SUBMIT
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