Hair Services Consent and Waiver form

Thank you for choosing YOUR SALON NAME!

Here at YOUR SALON NAME, we are commited to providing you with professional and top-notch services and products. Please read and complete the following form as thoroughly as possible to help us meet this goal.

Name:

Phone Number:

Email:

Address:

DOB: *

Have had any past reactions to hair color products?

If so, please describe:

Patch Test: I understand that a small percentage of individuals can experience adverse reactions when receiving the application of hair color products. These reactions are rare, but can include swelling, itching, and burning even if you have had your hair colored in the past without reaction. Your stylist can perform a match test to determine whether you will experience a reaction to coloring. This test should be completed 48 hours before your appointment to have your hair colored. You have the right to request a patch test prior to any service.

Would you like to schedule a patch test?

Corrective Coloring: Corrective coloring can mean:

1. More expertise and time will be needed than what is required with a "standard" coloring.

2. Reconstructive treatments may be required before coloring is completed.

3. You may need multiple visits to achieve the desired color.

4. Each visit will be considered a separate service and therefore a separate cost will be quoted for all visits.

Is this service considered a corrective coloring?

Informed Consent: Signing below indicates that you have read and understood this form, and that you agree to YOUR SALON NAME proceeding with hair coloring services. Signing below indicates your consent and agreement to defend and hold harmless YOUR SALON NAME, its owners, agents, and stylists from any liability claim or action arising from the application of hair coloring products.

Printed Name:

Signature:

Date: