Questionnaire - Image By Buckley

Image Consultation Questionnaire

Getting To Know You

Please complete our Image Consultation Questionnaire below as the starting point to assist with your consultation planning.

There is no cost or commitment to complete the Questionnaire.

Pro Tip: Save Your Work

Your entries on this questionnaire can be saved at any point and returned to later before submitting them by clicking on the SAVE AND CONTINUE LATER link at the bottom of the form. Doing so will display a unique link on the page for you to copy and email to yourself.

To return later, simply visit the link you have saved and emailed to yourself.

The work on this questionnaire is required and well worth the effort. Get started now and not lose your progress!

The Questionnaire

(Four-part questionnaire)

"*" indicates required fields

1Professional Details

2Social Media, Casting & Sizing

3Styling Info

4It's A Wrap

Contacts

Name*

First Last

Preferred Pronouns

Referred By

Email*

Phone*

Do you live in the Los Angeles area?*

Yes

If not Los Angeles, please provide your location.*

City State

Professional

Which services are you interested in?*

Headshot Styling

Audition Styling

Lifestyle Styling

Photographer Selection

Other

Describe other services...*

Please expand briefly on what you're hoping to achieve from us working together. (1-5 sentences)

Union Status*

SAG-AFTRA

SAG-e

Non-Union

Other-Union

Please note which other union you belong to here.*

Do you have representation currently? (Agent/Manager)*

Yes

Your Agent

Your Manager

Are you currently seeking representation?

Yes

What type of representation? (Commercial, Theatrical, Print, etc.)

Do you have any plans to move to another market or do you currently work as a local in markets other than the one you’re currently located in?

What is the #1 thing you’re hoping to achieve in your career right now? (i.e. I want to book my first co-star / I want to level up from co-star to guest star)

Social Media and Casting Profiles

Actors Access

LA Casting/Casting Networks

Personal Website

Instagram

Twitter

Other Social Media/Casting Profiles

Link to Demo Reel

Link to 1-2 Recent Self-Tapes

Sizing

Height

Weight

Are you interested in fittings for extended sizes?

Petite

Plus

Big & Tall

Other sizes

Please describe other sizes...*

Hair Color/Length

Eye Color

Shirt Size

Bra Size (If applicable)

Dress Size (If interested in dresses)

Pant Size

Are there any fit issues you frequently encounter that I should be aware of? (i.e. I have broad shoulders, so I prefer stretchy tops and need to size up in jackets)

Are there any additional fit/style preferences that I should be aware of? (i.e. I prefer to avoid tank tops)

Please upload a recent photo of yourself.

Accepted file types: jpg, gif, png, jpeg, Max. file size: 5 MB.

Please link any applicable Pinterest boards that represent the styles/looks you are hoping to achieve.

Specific Styling Information

Based upon your previous selections for Services you are interested in, you're interested in help with Selecting a Photographer, only. Please click NEXT to complete this section.

Headshot Styling

How many looks are you hoping to shoot in your headshot session?

Please denote the looks you’re hoping to achieve in your headshot session. (i.e. young professional, girl next door, quirky best friend, etc.)

Have you previously done any branding work with a career coach or in a class setting or received any kind of professional feedback on your "type?" Please describe below.

Do you need help being matched with a career coach to explore/discuss your type? ***If you do not yet have an idea of the looks you want to achieve in your headshot session, I highly suggest meeting with a career coach before we begin working together to guarantee the best results.

What is your playable age range?

Would you consider yourself more of a comedic or dramatic actor or a mix of both?

Please name 3-5 current TV shows that you can see yourself being cast in.

Are you already scheduled to shoot with a specific photographer? If so, who, and when?

Do you need help being matched with a photographer? If yes, please explain why and what you're looking for in a photographer and I will follow-up with referrals.

Are there any looks that your representation has requested that you shoot? ***I highly recommend consulting with your representation before we begin collaborating to make sure everyone is on the same page.

Why are you seeking new headshots at this time? What was missing from your old ones/why aren’t they working for you anymore?

Please name 3-5 actors that you are similar to.

What is your estimated budget for shopping, if needed?

Audition Styling

Please name the 3-5 “character types” that you are called in for most frequently.

Please name 3-5 current shows that you think you could be cast in or that you have recently been called in for.

Are there any specific gaps in your audition wardrobe that you’re hoping to fill? Please explain.

What is your playable age range?

Do you typically go out for more comedic or dramatic material? A mix of both?

Please name 3-5 actors that you are similar to.

What is your estimated budget for shopping, if needed?

Lifestyle Styling

Why are you seeking lifestyle styling at this time? (i.e. I have a specific event coming up, I need more professional clothing)

Are there specific pieces you’re hoping to add to your wardrobe at this time? Please describe.

Describe your personal style in three words.

Where do you find yourself shopping most frequently?

Other Styling

If you do not see the type of styling you’re looking for listed above, please briefly describe what you’re hoping to achieve from us working together here.

It's A Wrap

Choose your Image Consultant?

If you'd like to pre-select your image professional, let us know. Calendar and availability limitations may apply.

Buckley Sampson

Emma Mercier

First available, no preference

May we email you a copy of your questionnaire results?

Yes

Consent*

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