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INTAKE FORM

PERSONAL INFORMATION

EMERGENCY CONTACT INFORMATION

HAIR HISTORY + PREFERENCES

How would you describe your natural hair colour?
Blonde
Brunette
Redhead
Black
Grey
Other
How would you describe your natural hair type (Select all that apply)
Have you previously coloured your hair before?
Yes
No
Are you currently taking any medications that may affect your hair (e.g., thyroid medications, acne medications, etc.)?
Yes
No
Do you have any known allergies, particularly to hair products or ingredients?
Yes
No
Have you ever experienced adverse reactions to hair coloring?
Yes
No
Are you comfortable in front of camera for pictures & videos?
Yes
No
Do you have any experience modelling?
Yes
No

Please upload pictures of the front view, side view, and back view of your current hair in indirect natural light (this gives us a better idea of what we're working with)

MODEL AGREEMENT

PHOTOS + VIDEOS

CONFIDENTIALITY

WAIVER OF LIABILITY

Date

MODEL INTAKE FORM

We're excited to welcome you as a model for Blends by Chan! To get started, please fill out our model intake form and model agreement. This helps us assess what services will be best for you. Our team will review your submission and get back to you with next steps.

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