Client Profile Form
Personal Data
First Name:
Last Name:
Address1:
Address2:
City:
State:
Zip/Postal Code:
Country:
Phone (day):
Phone (eve):
Fax:
Email:
Age Group:	18-26 27-35 36-44 45-53 54-62 62+
Birth Month	January February March April May June July August September October November December
Birth Day (i.e. 24th)
Hair
Hair Color:	Blonde Light Brown Dark Brown Black Gray Strawberry Blonde Red Auburn
Other Hair Color
Services
What Services would be most helpful to you (please check all that apply):
Personalized Color Analysis
Makeup Instruction
Style Analysis
Hair
Presentations/Seminars/Workshops
Makeup Application for Weddings, etc.
Wardrobe Audit, Organization & Planning
Accessorizing
Personal Shopping
Other
Color Analysis
If you have been color analyzed, were you a:	Summer Winter Spring Autumn
Do you refer to these colors when you shop?
MakeUp Information
Do you currently wear makeup?
If yes, would you consider it:	Natural Moderate Dramatic
Shopping Habits
Do you like to shop?
If not, what do you find most frustrating about it?
Image Concerns
What are your three most pressing image concerns: