HAIRDRESSING - CLIENT RECORD CARD Name * First Name Last Name Email * Street: Town: Postcode: * Telephone Number: Date of Birth General Practitioner: * Address and Phone number: Have you ever suffered from hair loss Yes No Have you ever been diagnosed with alopecia? Yes No Do you take any medication Yes No Have you been pregnant in the last 6 months Yes No Do you suffer from psoriasis to the scalp Yes No Do you suffer from eczema to the scalp? Yes No Do you have a sensitive scalp? Yes No Have you any known allergies? Yes No Do you frequently swim or go to the gym? Yes No Do you have any upcoming holidays booked? Yes No Do you currently colour your hair Yes No If yes, how often? Have you used hair extensions before? Yes No If yes, which method? How would you describe your hair type Fine Medium Thick Very think Hair is: Curly Wavy Straight Frizzy Length: Above the shoulder Below the shoulder Have you applied any bleaching or colouring products to your hair since your last visit to our salon? Yes No If yes, when was this applied? Was it applied to: Roots only All over What was the make of colour used? Colour/No. of colour shade used Thank you!
