Client Contact Information

BeachHair OceanHair Salon & Spa

Note: All personal information is held securely in accordance with the appropriate legislation, is confidential and treated
appropriately.

Client Information
Mr/Mrs/Miss/Ms/Other
_________________
Last Name_________________________________
Name You Like To Be Called
______________________________________________________________
Address _______________________________________________________________________
______________________________________________________________________________

Telephone Numbers/Contact Details

Home
Work

___________________________
___________________________________

Cellphone
Pager

___________________________
___________________________________

Fax

___________________________

Email/s

__________________________________________________________________

Preferred Contact Mode/s

___________________________________________________________
Employment Information
Occupation
_______________________________________________________________________
Employer Name _________________________________________________________________
Personal Information
Date of Birth ___________________________
Marital Status _____________________________
No. of Children

_____________________

Client Contact Information

BeachHair OceanHair Salon & Spa

Significant Others Name

___________________________________________________________
Significant Others Date of Birth
_____________________________________________________
Significant Dates (eg. Wedding anniversary)
____________________________________________
Name(s) and Age(s) of Child(ren)
_____________________________________________________
Products Used
Formula
Time Processed