New Client Intake Form
Hello, Thank you for considering Asia D. Artistry. 

PLEASE DO NOT BOOK ANY SERVICES UNTIL YOU HAVE BEEN CONTACTED BY ME FIRST. 

Please take a moment to fill out the following questionnaire.  This will help me determine your next steps & get you one step closer to securing your first appointment.  You will be contacted by text or email, so please ensure to provide your correct contact information. 

Forms are checked on the last Monday of each month. 

Please use complete first and last names when filling out this form. 
Sign in to Google to save your progress. Learn more
First & Last Name *
Cell Phone # *
Email *
How do you prefer to be contacted?  *
Is this request form for a child? *
If so, What is his/her First & Last Name and Age?
Please confirm your contact information above correct? *
Service you are inquiring about ? ( Select all that apply.) 
***Please note that I do not offer/service, sister locks, sister lock extensions or wicks.***
*
Required
Do you have any breakage  or damage ?  *
If So, Please Explain. If not please type, " I have no damage."  *
Is your hair chemically treated  or have been chemically treated within the last 1-2 years ? ( Color, perm, relaxer, etc. ) *
If so,  please elaborate on the type of service and time frame.  If not, please type, " My hair has not been chemically treated."  *
Do you have any allergies to nuts, products, ingredients  & or essential oil?  *
If so, please describe here. 
Will you be traveling from out of town for your appointment? (1 hour or more) *
Leave me brief memo about your desired service & let me know if there is anything I need to know about your hair.  *
How did you hear about Asia D. Artistry ?  *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy