New Client Form

Welcome!

To better serve you, please fill out this new client form in preparation for our consultation.

This form is to help me get to know you better and estimate the amount of time we need for your first appointment.

-Eileen

Name

Email Address

Birthday

Addess

Phone

State/ Zip Code

City

Occupation

Allergies

Preferred Appointment Date and Time

Referred by

Common hair products used:

Common retail hair products purchased:

What do you like and dislike about your hair?

When was your last salon visit?

What type of service are you inquiring about? Check all that apply: What type of service are you inquiring about? Check all that apply: Haircut Color/ Highlight Treatments Facial waxing/ brow shaping Other

How would you describe your professional style? How would you describe your professional style? Corporate Business Casual Creative Casual

How would you describe you personal style? How would you describe you personal style? Classic Modern Trendy Natural

What are your hair goals? What are your hair goals? Subtle change once a year Change with the seasons Have a major change in mind Love to change ever visit

How often do you commit to salon visits? How often do you commit to salon visits? 1 -6 weeks 7 - 12 weeks 3 - 6 months Once a year

On average, how long does it take to style your hair at home? On average, how long does it take to style your hair at home? Less than 15 minutes 15 - 30 minutes 31 - 45 minutes More than 45 minutes

How do you style your hair? How do you style your hair? Air dry or lightly diffuse Blow-dry with a flat brush Blow-dry with a round brush Blow-dry with a brush and hot iron

How comfortable are you when styling your own hair? How comfortable are you when styling your own hair? Uncomfortable Comfortable Very Comfortable Would like guidance

How would you describe your hair's abundance? How would you describe your hair's abundance? Sparse Average Thick

How would you describe your hair? How would you describe your hair? Straight Wavy Curly Kinky

What is your hair's condition right now? What is your hair's condition right now? Normal Dry Distressed Porous

What is the condition of your scalp? What is the condition of your scalp? Dry Oily Acne Other

What is the reason for your visit? What is the reason for your visit? I am not in LOVE with my current hair color/cut My hair is damaged and I need help/ I am looking for hair care recommendations I am just visiting and need my hair done. I like it how it is, just need a touch up. I am happy with my hair, just need a new stylist.

Why are you looking for a new hair stylist? Why are you looking for a new hair stylist? I felt like my previous stylist was not listening to me/ did not pay attention to me. My stylist moved and I am devastated and desperate. I am new to the area and was referred to you/ found you online. I have never liked my hair. Other

I am not just looking for another hairstylist, but a hairstylist who personalizes my appointments, educates me on my own personal hair, how and what I should use to maintain it at home, teach me new styling techniques and what is possible and safe/ healthy for my hair. I'm looking for a hairstylist who customizes color/treatments/cuts/etc. I am looking for recommendations based off of my dream hair and what will work for my own personal needs for the number of visits, the amount of time for appointments and how often I can maintain my new look. I am not just looking for another hairstylist, but a hairstylist who personalizes my appointments, educates me on my own personal hair, how and what I should use to maintain it at home, teach me new styling techniques and what is possible and safe/ healthy for my hair. I'm looking for a hairstylist who customizes color/treatments/cuts/etc. I am looking for recommendations based off of my dream hair and what will work for my own personal needs for the number of visits, the amount of time for appointments and how often I can maintain my new look. Yes No

I have read and agree to the policies stated below. I have read and agree to the policies stated below. Agree Do not agree

I am willing to sign a consent release form confirming that I am aware of the threat of Covid-19 and do not have any symptoms of the virus. (Link to consent form below) I am willing to sign a consent release form confirming that I am aware of the threat of Covid-19 and do not have any symptoms of the virus. (Link to consent form below) Yes No

Policy

Your appointments are very important to Eileen. We hold your appointments just for you and ask that if you must cancel or reschedule any appointment, please provide Eileen with 48-hour notice. If you fail to cancel or reschedule within 48 hours of your appointment, you will be charged 50% of the service price.

Agreeing to this policy by clicking “agree” above, you acknowledge that you will receive hair care services, for the cost discussed, which may include, but not limited to cut, style, curl, treatments, facial waxing, and color services. You understand that Eileen, a trained and licensed professional, at their discretion, will do all of the work. You agree to not hold Hair By Eileen responsible for any personal dissatisfaction, adverse effects cause by the product or services performed, or loss of any personal items (which may have been left behind/ unattended) and waive any right to vicil action.

You give permission to use your name, photos, and video on social media, publications, productions, distribution or broadcast therof. You understand that you are representing Hair By Eileen and will maintain a positive and professional image during the entire process.

You agree to sign a COVID-19 Consent Release Form that is in line with the Texas’ new cosmetology/ hair salon guidelines.