search
Make Appointment: Call 718-422-2600
Consultation Questionnaire
In the event that you do not hear from us within 48 business hours, please contact us at (718) 422-2600 to confirm
that we have received your consultation form.
  [*] Are required fields
* Name:
* Email Address:
Mailing Address:
* Cell Phone:
* Alternate Phone:
Age:
Condition of your hair:
Goals: Tell us
what you would like to achieve with your hair
How are you currently wearing your hair?
Do you use a
chemical relaxer?		 Yes   No
Do you flat iron your hair? (Please check at least one) Yes   No
When did you have your last chemical relaxer? (Please check at least one)
If so, when
was the last time?
Do you take any medications, vitamins, etc.? Please describe:
Please describe your diet:
How are you currently wearing your hair?
How often
do you have a trim?
When was your last trim?
Do you generally get...
Professional care
Do-it-yourself?
Texture of hair: Using a scale from 1-10, with 1 being very straight
texture and 10 being tightest curl (very kinky),
please give us an idea of your hair texture.
Density:
Would you consider
your hair to be
Very thick
Somewhat thick
Medium thickness
Thin
Very fine
Hairline:
Is your hairline
Healthy
Thinning
Bald
Hair Length:
Please check the hair
length that most accurately
describes the length of your hair.
What are you
expecting from us?
Anything else
you want us to know...
Hair Coloring; If you are interested in having your hair colored or a color correction,
Please answer the following questions. If not skip this section and submit.
Has your hair been
colored already?		 Yes   No
Have you noticed
any significant dryness of
your hair since coloring?		 Yes   No
If so, how often
do you have your
hair colored? When was
your last color treatment?
   
What color is your hair now?
what color would
you like to achieve?
* Obligatory fields
Terms & Conditions • Privacy • About Us
© 2012 Khamit Kinks