Glam Designs Image Consultation Questionnaire

Questions marked with an * are required

Exit Survey

* First Name :

* Last Name :

* Address 1 :

Address 2 :

* City :

* State :

* Zip :

* Phone :

* Email Address :

Age

How would you describe your current style?

Reason for Consultation: (What would you like to improve on? What is your ideal look that you wish you could have?)

What size do you wear? Dress Size

Pants Size

Shirt Size

Shoe Size

I need the following measurements: height, weight, bra size, waist (at the belly button), hip (fattest part of the butt/hip), chest (around you’re the middle of your chest while wearing a bra). Formal wear stores will take your measurements for free, if you are unsure. What is your height?

Weight

Bra Size

Waist

Hip

Chest

What is your current occupation?

What do you usually wear to work? Are you happy with what you wear to work?

Favorite Colors?

Favorite outfit that you wear now? Favorite outfit that you have ever worn?