NEW CLIENT INTAKE & CONSULTATION FORM [Salon name] This template is provided for general information only and is not legal or medical advice. An intake form collects personal, and sometimes health, information, so you are responsible for storing it securely and using it lawfully. Privacy rules (such as GDPR, UK GDPR, CCPA, PIPEDA) and rules on patch tests, consent, and treating minors vary by state and country. Confirm this form meets the law where your business operates, and have a qualified advisor review it before use. Welcome to [Salon name]. Please complete this form so we can give you a safe, personalized service. Your answers are kept confidential. Date: ____________________ CONTACT DETAILS Full name: _______________________________________________ Phone: ____________________ Email: ____________________ Date of birth: ____________________ Address: _______________________________________________ Emergency contact (name & phone): _______________________________________________ How did you hear about us? _______________________________________________ TODAY'S VISIT Service(s) you would like: _______________________________________________ Preferred stylist or therapist (if any): ____________________ What result are you hoping for? _______________________________________________ Where did you last have this service, and when? _______________________________________________ SERVICE HISTORY Have you had any of the following recently? Please note dates or products used. Color, highlights, or chemical treatment: _______________________________________________ Keratin, relaxer, perm, or straightening: _______________________________________________ Home color, box dye, or henna: ____________________ If yes, when? ____________________ How would you describe your hair / skin / nails right now? _______________________________________________ ALLERGIES & SENSITIVITIES Do you have any allergies or sensitivities (e.g. to dyes, latex, fragrance, nickel, adhesives, products)? _______________________________________________ Have you ever reacted to a salon product or service? If yes, describe: _______________________________________________ HEALTH INFORMATION Some conditions and medications can affect a service. Please tell us what is relevant. Medical conditions we should know about: _______________________________________________ Medications or supplements you take: _______________________________________________ Are you pregnant or breastfeeding? ____________________ Any skin conditions, recent surgery, or injuries in the treatment area? _______________________________________________ PATCH TEST (COLOR & CHEMICAL SERVICES) For color and some chemical services, a skin patch test may be required before your appointment. Patch test completed? [ ] Yes, on ____________________ [ ] Not required for my service [ ] I decline (I understand the risk) Client initials: ____________________ PHOTO & SOCIAL MEDIA May we photograph your service and use the images on our website or social media? No names are shared. [ ] Yes, I consent [ ] No Client initials: ____________________ STAYING IN TOUCH May we contact you with appointment reminders and occasional offers? [ ] Yes, by text [ ] Yes, by email [ ] No, appointment matters only You can change this or unsubscribe at any time. SALON POLICIES I have been informed of the salon's cancellation and no-show policy, and I agree to give the notice required to cancel or reschedule. Client initials: ____________________ CONSENT & ACKNOWLEDGMENT The information above is true and complete to the best of my knowledge. I understand it helps the salon provide a safe service, and I will update the salon if anything changes. I release the salon from liability for reactions arising from information I did not disclose. Client signature: _______________________________________________ Print name: ____________________ Date: ____________________ Parent or guardian (if client is a minor): _______________________________________________ Stylist / therapist: ____________________ [Salon name]