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574.272.6767
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Heritage Square
Downtown
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Heritage Square
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Downtown
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Contact information
Name
Last Name
Date of Birth
Phone Number
Email Address
Gender
Female
Male
Other
How did you hear about us?
Facebook
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Questionnaire
When was your last hair cut done?
3-4 months
5-6 months
6 months +
When was your last hair color done?
3-4 months
5-6 months
6 months +
What brand of hair color used?
Store bought
Salon
What is your hair history of the last 3 years?
What level of change are you looking for?
Completely Change
Slightly Modify
Maintain
Unsure
What color is your hair currently?
Blonde
Brunette
Black
Red
Other
If your previous services are by a professional, why do you want to change hairdresser? What don’t you like about your last hairdresser?
What shampoo, conditioner an other products do you use in your hair?
What is your hair length?
Short
Medium
Long
What is your hair natural texture?
Straight
Wavy Or Curly
What is your hair density?
Fine
Medium
Thick
Intake & consultation form
What are your top hair concerns?
Dry
Aging
Brassiness/Yellow Tones
Limp/Flat
Damaged/Brittle/Fragile
Frizzy
Thinning
Dull
Oily
What is your desired result?
Smooth Volume
Textured Volume
Curly/Wavy
Smooth/Straight
What do you love most about your natural hair?
How often are you willing to come back to the salon for maintenance?
Every 1-2 months
Every 3-4 Months
Every 5-6 Months
How would you best describe your hair health?
Healthy and shiny
A bit damaged
On the road to recovery
Not happy!? Please help
Which is most important to you?
Getting to my goal as quickly as possible
Maintaining the integrity of my hair/losing little length
Please upload your hair inspo
Upload
Please upload a photo of your current look
Upload
Submit
Please call us at
574-272-6767
to request your appointment