Scheduling Form Google Calendar Scheduling Practitioner Name Appt date Date HH MM AMPM Client's name Phone number Number of people coming? Ages Will parents want to be checked for lice also? N/Ayesno Child 1 Hair Length N/AShoulder BladeWaistShortShoulder Child 1 Hair Texture N/AFineCoarseAA Child 2 Hair Length N/AShoulder BladeWaistShortShoulder Child 2 Hair Texture N/AFineCoarseAA Child 3 Hair Length N/AShoulder BladeWaistShortShoulder Child 3 Hair Texture N/AFineCoarseAA Adult 1 hair Length N/AShoulder BladeWaistShortShoulder Adult 1 Hair Texture N/AFineCoarseAA Adult 2 Hair Length N/AShoulder BladeWaistShortShoulder Adult 2 Hair Texture N/AFineCoarseAA Had Head Lice before? N/Ayesno How recently did you have lice? Been to NW before? yesno Did you see nits and bugs or only nits? Who diagnosed? N/Aschool nursepediatricianfriendself Did you already do lice treatment ? N/Ayesno Do you have Terminator Comb? N/Ayesno