Eric Client Intake Form

Appt Date:

First Name (required)

Last Name (required)

Email (required)

Mobile Phone:

Home Phone:
Work Phone:


City: State: Zip:

Client Age: Birthday:



Sizing Information

Weight: Height:

Shirt-Neck: Shirt-Sleeve:

Coat Size:

Pants Size:

Pants Waist:

Pants Length:

Shoe Size:

Wardrobe Information

I need help putting together outfits for:
WorkCasual OutingsEventsOther

I want to learn more about:
How to shop on my ownHow to use clothing in multiple waysHow to step it up a notchHow to be dressy causalWhat is best for my body typeHow to dress for my current life situationOther


Client Response

Other Details