Consultant Survey

A client intake survey used before a skin and hair care consultation, covering allergies, current routines, and preferences so the consultant can recommend the right products and treatments.

Use this template

Name

Nombre

Apellido

Phone Number

Address

Dirección

Ciudad

Estado / Provincia

Código postal

Date

Education

High School Associate Degree Bachelor's Degree Master's Degree Doctorate

Check any interests that you like:

Any known allergies to skin/cosmetic products?

Please describe your skin care routine

Duration

Less than 1 year 1 to 3 years 3 to 5 years More than 5 years

Favorite skincare brand(s)

Do you have extremely dry skin?

Yes No

Do you have lines/wrinkles compared to peers?

Yes No

Do you have uneven skin tone?

Yes No

Do you have redness?

Yes No

Do you use sunscreen? If yes, what SPF?

Are there any particular ingredients you avoid in hair and skincare products? If yes, explain:

Yes No

What type of hair do you have?

Straight Wavy Curly Coily

Do you have scalp problems?

Yes No

Please give details

Have you had any side effects from hair or skincare products? If yes, explain:

Yes No

Please give details

Please briefly describe your hair care routine

How often do you buy hair and skincare products?

What products do you use?

In a typical week, how many different types of hair and skin care products do you use (shampoo, conditioner, mousse, treatment, hair spray, grease, gel, stylers, lotions, body wash)?

How do you select products?

Gender

Female Male Other Prefer not to say

Any further explanation or concerns? (use the space below)

Consultant Survey

Related templates