Hair Color & Henna Color Consent Form

Please print clearly and fill in ALL that is applicable. Information is kept confidential.

Full Name:

Email Address:

example@example.com

Phone Number

Area CodePhone Number

Birthdate

Date

Initial if you refuse a 24 to 48 hour patch test

All appointments are booked with a 50% non refundable deposit. If a deposit is not taken while booking your follow up appointment, your account will automatically be charged 1 week before your appointment. If the deposit is not collected, your appointment may be cancelled.

I understand and agree

How did you hear about our salon?

We look forward to proving the best natural hair color service possible. If we feel that your hair is not healthy enough for the service(s) requested, we do reserve the right to decline providing the service(s).
I, the undersigned, hereby voluntarily agree to accept the services and terms noted below by any cosmetologist/Natural Hair practitioner working for the services performed. In agreeing to have such services performed, I am fully aware that there are potential risks involved in receiving any salon service and in the use of cosmetology products and chemicals including but not limited to possible allergic, chemical, or other adverse reaction which might cause illness, discomfort, or even allergic reactions. I, the undersigned, herby release Taji Natural Hair Styling Styling and any cosmetologist/ Natural Hair Practitioners working there of any and all liability for any harm, injury, illness, damage, claims, discomfort, demands, action, causes of action. As well as costs/expenses of any nature that I might have or that may hereafter accrue to me, arising out of or related to any such injury, illness or discomfort, that may be sustained by me as a result of the services provided by a cosmetologist/Natural Hair practitioner of Taji Natural Hair Styling. Further, I affirmatively state that I have no illness or health condition which might be aggravated or otherwise adversely affected by the procedures I am obtaining from Taji Natural Hair Styling or any cosmetologist/Natural Hair practitioner working there. I am aware that I may request to wear a protective chemical gown; however, this gown may not serve to completely protect me and/or my property. I declare that I am competent to sign this consent and release of liability form and that I execute this document freely, knowingly, and voluntarily. I understand this form will apply to ALL visits and ALL services provided by Taji Natural Hair Styling and working cosmetologists/Natural Hair practitioners.

Appointments canceled within 48 hours or less of the scheduled time will incur a fee equal to 50% of the service rate. Missed consultations will be charged the full price, $10. All appointments are booked with a non refundable deposit.

Client Signature:

Date:

Date

Signature of parent/guardian if client is a minor (under the age of 18)