Client Intake Form 

Our sincerest is to provide you with the best hair care services you've ever received! In order for us to do so, we would like to learn more about you, your hair care needs, and your preferences. Please take a moment to answer the questions below as completely and as accurately as possible. Thank you and we look forward to building our relationship! Name: __________________________________________________________________________________ Last First Address:

Phone: Email address:

Sex: Male Female

If you were referred, who referred you?

Please answer the following questions. Thanks!

1. Approximately when was your last salon visit? 2. In the past year have you had any of the following services either in or out of a salon?

__ Haircut __ Haircolor __ Permanent Wave or Texturizing Treatment __ Chemical Relaxing or Straightening Treatment __ Highlighting or Lowlighting

__ Manicure __ Pedicure __ Artificial nail services (please describe) __ Facial/Skin Treatment __ other (please list any other services you've enjoyed at a salon that may not be listed here).

3. What are your expectations for your hair service(s) today?

4. Have you ever been allergic to any of the products, treatments, or chemicals you've received during any salon

service -hair, nails, or skin? (Please explain) 5. Are you currently taking any medications? (Please list)

6. Please list all of the products that you use on your hair on a regular basis. 7. What tools do you use at home to style your hair? 8. What is the one thing that you want your stylist to know about you/your hair?

9. Are you interested in receiving a skin care, nail care or makeup consultation? Yes No 10. Would you like to be contacted via email about upcoming promotions and special events? Yes No

Statement of Release: I hereby understand that supervised cosmetology students render these services for the sole purpose of practice and learning, and that by signing this form, I recognize and agree not to hold the school, salon its employees or the student liable for my satisfaction or the service outcome. Client signature: ______ Date:

.

Supervisor:                                                                     Cosm

etologist:                                                                    

Ms. Ly

Name: _________________________ ________________________ Last First

Instructions: Answer the questions below using information from your readings and lessons as a guide.

Ergonomics Review 1. Why is good posture an important part of your physical presentation?

2. List the guidelines for achieving and maintaining good work posture.

3. Define ergonomics.

4. Give an example of fitting the job to the person in the salon.

5. What parts of the body can be injured by repetitive motions?

6. What steps can you take to avoid injuries from repetitive motion?

Communicating for Success Review

GROUP: Client consultation and handle client complaints

1. What is the best way to handle a scheduling mix-up with a client?

2. List strategies for dealing with an aggressive client.

3. What is the best way to decide how to address new clients?

4. You are performing a consultation on a stylish, younger client when she uses a slang term to describehow she would like to look. You have no idea what the word means. What should you do next?