Healthy hair begins with us!

The First Avenue Hair Design team would like to thank you for choosing our salon. We value your business and your input.
 Please provide the requested information to help you reach your hair care goals! 
Your information is safe with us and will not be passed on to any third-party.
FILL OUT COMPLETELY AND EMAIL BACK TO US!
CONTACT
Name: 
Date:
Email:  
Primary Contact Number:
Address:  
Zip:
Birthday:
Occupation:
Can we add you to our networking list to promote your business?
PREFERENCES
How did you hear about us? Referred by:
Preferred Appointment Day :
Time:
:
In order to give you the best shampoo or neck massage, what pressure do you prefer?
Please select your preferred magazine genre:
Beverage preference Water, Tea or Coffee?
HAIR TREATMENT
Which hair care product(s) do you use?
When you moisturize your hair do you use cream, oil or both?
What is your current hair care routine?
When was the last time your hair was professionally cut?
What best describes the state of your hair (ex. Crunchy, Limp, Stringy etc.)
Describe your hair density
What is your hair length
Do you currently have a relaxer?
If so, when was the last application?
HEALTH & LIFESTYLE
Your overall health is a relevant factor in providing professional hair care please. (Check ALL that apply)
Do you or anyone in your immediate family have alopecia disorder or hair loss?
If so are you seeking professional assistance?
Do you exercise regularly?
Describe your hair goals and any concerns you may have about your hair
First Avenue Hair Design would like to THANK YOU for taking the time to answer the above questions. This client profile enables our stylist to offer the highest quality of hair care and treatment.

DISCLAIMER
____ I have completed this questionnaire truthfully and to the best of my ability, I understand that withholding information or NOT providing this information may result in complications with hair and or irritation to the skin. I understand that this information will not be shared with a third party.

Copyright © 2015. First Avenue Hair Design. All rights reserved
​8713 First Avenue Silver Spring, MD 20910                 Phone: (301) 589-0288                            Email: 1stavehair@firstavenuehairdesign.com


Healthy hair begins with us! 
​8713 First Avenue Silver Spring, MD 20910            Phone: (301) 589-0288                  Email: 1stavehair@firstavenuehairdesign.com
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CONSULTATION FORM
YesNo
Weekly
Bi-weekly
Other
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LightMediumIntense
Health and Fitness
Fashion
Home Decor
Celebrity Gossip
Travel
Other:
WaterTeaCoffee
Thin
Medium
Thick
Course
Fine
Oily
Dry
Long
Medium
Short
YesNo
Circulatory Disorders
Diabetes
Thyroid Disorder
Skin Disorders
Pregnant
High Blood Pressure
Lupus
High Stress
YesNo
YesNo
YesNo