Re-Texturizing Consultation Form
This consult is for those interested in Japanese Straightening (also known as Thermal Reconditioning), Straight Variation, and the Curl Reformer.
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Have you ever had color, highlights, glaze, or henna in the last 5 yrs? If so, please describe below what service you've received and when.
Have you ever had any texture altering service i.e. relaxer, texturizer, perm, Keratin treatment in the last 5 years? If so, please describe service received and when.
Are you currently pregnant or can possibly be pregnant?
Are you currently on any medication relating to high blood pressure, immune-deficiency diseases, cancer treatment, hormone altering medications (like birth control), Retin-A or are you vitamin deficient, enough to be treated with prescription vitamins? If so, please list type of medication you are currently taking.
Have you had any surgery recently or procedures that warranted the use of general anesthesia? If so, when was the procedure performed?
Please upload current pics of your hair in its natural state from different angles- front, back, and side.
I understand that a payment of $100 is due at the time of scheduling my appointment. This will be applied to my service. If for any reason I miss my scheduled appointment or fail to give 72-hour notice to change my appointment, I will forfeit my $100 deposit. All information disclosed above is true to the best of my knowledge. I understand that any previous chemical services were disclosed. I understand that all information given is important to ensure the best results and will be held in the strictest of confidence.
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