Intake Form - The Tressing Room

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Intake Form

Thank you for choosing The Tressing Room! This form helps us get to know your child, understand their hair needs, and prepare for a safe, comfortable, and successful appointment. Please complete each section as accurately as possible. Most families complete this form in about 5–10 minutes.

Parent/Guardian Information

Parent/Guardian Name *

First

Last

you child Child's

Parent Phone Number *

Parent's Email Address *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Parent's Preferred Contact Method

Text Message
Call
Email

May appointment reminders be sent via text?

Yes
No

May I contact you if I need additional information before confirming your appointment?

Yes
No

May I contact you after your appointment regarding follow-up care or future appointments?

Yes
No

Child Information

Child's Name *

First

Last

Child's Birthday *

Child's Age *

How does your child typically respond to having their hair done? *

Loves it
Does well
Gets nervous
Cries occasionally
Strongly dislikes it
This is their first professional appointment

Hair History & Home Care

Has your child ever received professional hair services? *

Yes
No

Please list ANY and ALL services and styles your child has received in the past.

Examples include: wash, blow dry, straightening, cut, trim, braids, twists, extensions, loc styles and maintenance, crochet, chemical services, color services, treatments, relaxer, texturizer, perm, etc.

How sensitive is your child to detangling or scalp manipulation? *

Not sensitive
Mildly Sensitive
Moderately sensitive
Very sensitive
Unsure

What does your child typically do or say when detangling becomes uncomfortable? *

How often is your child's hair shampooed? *

Weekly
Every 2 weeks
Every 3-4 weeks
Longer than 4 weeks

What shampoo and conditioner are currently used at home? *

Please include the full brand name and description

What products are regularly applied between washes? *

Leave-in
Moisturizing cream
Oil
Grease
Gel
Edge control
Mousse/foam
Braid spray
Other
None

Please list the brand and name of the products regularly used on your child's hair. *

Include leave-ins, moisturizers, oils, grease, gels, edge control, mousse/foam, braid sprays, and other styling products.

Does your home have a water softener? *

Yes
No
Unsure

Does your child swim often? *

Yes
No

In what type of water does your child swim? *

Chlorinated pool
Saltwater pool
Natural water/ocean
Multiple

How often is heat used on your child's hair at home? *

Never
Less than once a month
1-3 times per month
About once a week
More than once a week
Unsure

Which heated tools are typically used? *

Blow dryer
Blow-dryer brush
Flat iron
Hot comb
Curling iron/wand
Other

How long does your child normally keep protective styles installed? *

Less than 1 week
1-2 weeks
2-3 weeks
3-4 weeks
Longer than 4 weeks
N/A

After removing braids, twists, or other protective styles, is your child’s shed hair normally detangled before shampooing? *

Yes, thoroughly
Usually, but not always
No
Unsure
My child does not typically wear protective styles

How often is your child's loose hair detangled/combed through between styles? *

Daily/several times weekly
Weekly
Only on wash day
Only during style changes
Rarely

How is your child’s hair typically protected at night? *

Satin/silk bonnet or scarf
Satin/silk pillowcase
Satin/silk sheets
Protective style (braids, twists, etc.)
Hair is not typically protected at night
Other

When was your child's hair last thoroughly detangled from roots to ends? *

Within the last 7 days
1-2 weeks ago
2-4 weeks ago
More than 4 weeks ago
Unsure

Current Hair & Scalp Condition

Does your child's hair currently have tangles, matting, or shed hair that has not been fully combed out? *

No
Some tangling
Significant tangling
Matted areas
Unsure

Please include photos of this in the uploads section.

Have you noticed unusual breakage, a change in texture, excessive shedding, areas of hair loss or thinning, or any other recent changes to your child's hair? *

No
Yes

Explain the recent changes you have noticed to your child's hair. *

Have you noticed any scalp scaling, flaking, redness, swelling, discoloration, unexplained patches, discharge, wounds, or any other skin differences on your child's scalp? *

No
Yes

Explain the skin differences you have noticed on your child's scalp. *

Have you seen a pediatrician or dermatologist regarding your child's scalp? *

Yes
No

When did you visit your child's medical professional and what was the outcome of your visit? *

Please provide the date of your child's medical appointment regarding their scalp. Briefly describe the recommendation of your child's provider and any medication your child has taken/currently takes for the concerns listed.

Hair Goals & Photos

Hair Goals

What are your goals for your child's hair?

Upload Photos of Your Child's Hair *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Please upload 3-5 recent photos of your child's natural hair. Include photos of the front, back, and side.

Upload Inspiration Photos of Your Desired Style *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Upload at least one photo of the hairstyle you desire for your child. The photo must clearly show sizing and length. No AI or hand drawings will be accepted.

Health Information

Allergies *

Please list all products, fragrances, environmental, animal, and food allergies.

Medical Conditions *

Please list any diagnosed medical conditions, medications, physical limitations, or health considerations that may affect your child's appointment. Enter “None” if none apply.

Sensory Considerations *

Please describe sensitivities to touch, scalp manipulation, water, spray bottles, combing, blow dryers, noise, smells, textures, or other sensory experiences. Enter “None” if none apply.

Behavioral Considerations *

Please describe any behaviors I should be prepared for during the appointment, including attempts to leave the chair, hitting, kicking, biting, scratching, throwing items, self-injurious behavior, or difficulty communicating needs. Enter “None” if none apply.

Comfort & Care

Is your child potty trained? *

Yes
Working on it
No

Does your child wear diapers or pull ups? *

Yes
No

If applicable, how would you like diaper changes handled?

I will return if my child needs a diaper change.
I authorize The Tressing Room to change my child's diaper if necessary.
This does not apply to my child.

How does your child typically communicate that they need to use the bathroom? *

Tells/asks independently
Uses nonverbal cues or gestures
Usually needs reminders
May not communicate the need
Requires assistance

Does your child have a typical toileting routine or bathroom needs you would like me to know about? *

Please include anything that may help me support your child during their appointment, such as how often they typically need to use the restroom, whether they need reminders, signs they may show when they need to go, assistance they may require, or other helpful information. Enter “None” if there are no additional needs.

Does your child have a comfort item they would like to bring? *

Stuffed animal
Blanket
Pacifier
Bottle/Cup
Tablet
Headphones
Sensory toy
Other

Does your child have any favorite activities? *

Coloring
Reading
Watching cartoons
Movies
Fidget toys
Conversation
Quiet time
Other

Is there anything that helps your child feel calm or comfortable? *

May your child be offered:

Water *

Yes
No

Juice *

Yes
No

Occasional snack *

Yes
No

Food allergies and dietary restrictions *

Emergency Contact

Emergency Contact Name *

First

Last

This person must be reachable and able to provide transportation for your child within approximately 15 minutes if needed.

Emergency contact relationship to child

Emergency Phone Number

Pickup Authorization

Besides yourself, who may pick up your child?

Name *

First

Last

Relationship to child *

Phone *

Is there anything else you would like me to know before your child's appointment? *

Please use this section to provide additional information. If you have selected 'other' for any question above, please also include details here.

How did you hear about The Tressing Room *

Examples: Facebook, Instagram, Tiktok, refferal, etc. For referrals, include the name of the parent or child that referred you so we may thank them.

Please read and agree to the following statements. *

I confirm that the information provided on this form is complete and accurate to the best of my knowledge. I understand that withholding, omitting, or providing inaccurate information about my child’s hair/scalp condition, medical or developmental needs, sensory needs, behaviors, or other factors that may affect their appointment may result in services being modified or declined. If relevant information was not disclosed prior to the appointment and prevents services from being safely or appropriately provided, I understand that my reservation deposit may be forfeited.

Please read and agree to the following statements. *

I understand that The Tressing Room relies on the information provided in this intake form to prepare for my child’s appointment and provide an appropriate, safe, and supportive service experience. I agree to contact The Tressing Room before the appointment if any information provided here changes or if there is additional information that may affect my child’s service.

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