* Required information
First Name*: Last Name*:
Date of Appointment *: Month/Date/Time:
Which Service Provider will you be seeing?
For which Service(s)*:
Best phone number to reach you at*: Which is a*:
Alternate Phone Number: Which is a*:
City*: State*: Zipcode*:
If by a current guest of ours, whom:
Birthday*: Sex*: Occupation*:
Describe your hair:
What is the CURRENT LENGTH of your hair:
What is the TEXTURE of your hair: (the hair strands)
What is the THICKNESS of your hair: (# of hairs)
What is the WAVE PATTERN of your hair:
What would you like to improve with your hair?(check all that apply)
Is your hair color treated?
If yes, which process:
When was the last time you had a color service?
Do you typically color your hair:
Is your hair permed or relaxed?
If yes, when was the last time you had a texture service?
What challenges do you currently have with your hair?
What challenges have you had in the past?
What is your goal for this appointment?
What products do you currently use at home? Please list all.
How much time do you spend on your hair in the mornings?
How much time would you like to spend?
How often do you shampoo your hair?
I use the following on my hair when styling (check all that apply):
Would you like your Service Provider to complete a Prescription based on your needs?
Would you like your Service Provider to teach you 'how' to style your hair at home?
If you don't mind, please tell us why you left your last salon/stylist? (no names please)
Have you ever tried bareMinerals?
If not, time permitting, would you like a complimentary Make under?
Is there ANYTHING else that you feel we should know that may help us make your experience better?
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receives this prior to your appointment.
Thank You so much for taking the time to complete this form. This will be an AMAZING tool for your service Provider to be able to meet your needs more effeciently.