New Client Form

Full Name:

Date of Birth:

Phone:

Email:

Current Living Address:

How did you hear about us?

What treatments are you interested in:

Do you live outside of Queensland?

Have you travelled in any hot spots in the last 14 days?

Do you have any of the following symptoms?

Fever, cough, sore throat, shortness in breath, aches & pains, headaches, runny or stuffy nose or diarrhoea? 

Have you read all Shea Beauty's Safety Information and understand your actions when coming into the salon?

Any Comments?