Located on the square, in Historic Downtown Leonardtown MD
301.475.5225
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NEW GUEST SURVEY

Please take a moment to complete the following form 24 hours prior to your visit. This will be reviewed by your Service Provider to enable them to get to know you better and be sure that your expectations are met. Be sure to click the 'SUBMIT' button upon completion. Thank you.

* Required information

First Name*:                                                   Last Name*:                 

Date of Appointment *: Month:                Date:            Time:                 

Service Provider*:                                        

For which Service(s)*:















Best phone number to reach you at*:                                               Which is a*:

Alternate Phone Number:                                          Which is a*:


Email Address*:                                                           

Mailing Address*:       

City*:                                                              State*:                                       Zipcode*:


Refered by*:                                            




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?






BE SURE TO HIT THE 'SUBMIT' BUTTON WHEN YOU ARE DONE.
This will ensure that your service provider 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.
DESIGN:
COLOR:
TEXTURE:
SKIN CARE/MAKE UP:
NAIL CARE:
TANNING:
(Please note)
Be sure to let us know so we can thank them!
BLOWDRYER
DIFFUSER
ROUND BRUSH
DENMAN/VENT

FLAT IRON
CURLING IRON
HOT ROLLERS
OTHER (please note)

CONSULTATION
HAIR CUT
SHAMPOO & STYLE
UPDO STYLE
CONDITIONING TREATMENT
COLOR GLAZE
DIMENSIONAL COLOR
COLOR RETOUCH
1ST TIME COLOR
DECOLORIZING (bleach)
CORRECTIVE COLOR
MENS CAMO COLOR
PERMANENT WAVE
RELAXER
CURL REDUCER
BRAZILIAN BLOWOUT
MANICURE
PEDICURE
NAIL ENHANCEMENTS
FACIAL TREATMENT
FACIAL WAXING
BODY WAXING
MAKE UP APPLICATION
MAKE UP LESSON
SPRAY TANNING
UV TANNING
OTHER:
DROVE BYNEWSPAPEREMAILDIRECT MAILYELLOW PAGESWEBSITEINTERNETWORD OF MOUTHOTHERFREIND/AQUAINTANCE (Please list whom)
FEMALEMALE
MORE VOLUME
MORE TEXTURE
MORE SHINE
LESS FRIZZ
CONTROL CURLS/FRIZZ
CONTROL DRY SCALP
REMOVE BUILD-UP
MORE SMOOTHNESS
MORE SOFTNESS
MORE CONTROL
REPAIR MECHANICAL DAMAGE
REPAIR CHEMICAL DAMAGE
YESNO
SHORTMEDIUMLONG
FINEMEDIUMCOARSE
THINMEDIUMTHICK
STRAIGHTWAVYCURLYKINKY
YESNO
DIMENSIONAL COLOR
SEMI/DEMI COLOR
PERMANENT COLOR
OTHER
IN THE SALONAT HOMESOMETIMES HOME, SOMETIMES THE SALON
PERMEDRELAXEDBRAZILIAN BLOW OUTNO TEXTURE SERVICES
0-5 MINUTES
5-10 MINUTES
10-20 MINUTES
20-30 MINUTES
30 OR MORE MINUTES
0-5 MINUTES
5-10 MINUTES
10-20 MINUTES
20-30 MINUTES
30 OR MORE MINUTES
YESNOMAYBE
YESNOMAYBE
YESNO
YESNOMAYBE
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO