Read and Accept:
By signing below, you attest that you have provided accurate and current information on this form and answered all medical and health-related questions truthfully and completely. Your signature also certifies that you understand that Samel’s Beauty Lounge, LLC reserves the right to deny service to any client due to a health condition he or she has that may pose a potential risk to the client, practitioners, or other clients and guests, including those risks that pose a danger of potential contamination to service areas.
Furthermore, signing below verifies that you understand that you are responsible for informing Samel’s Beauty Lounge, LLC and/or its stylists of ANY and ALL changes to your health condition as regards to any question on this form or any potential public health risk that may arise from any change in your health condition. You acknowledge and accept that withholding information, providing misinformation, or failing to update existing information may result in contraindications and/or irritation to the hair and scalp from treatments received.
By signing below, you grant permission for the hair care professional/practitioner/stylist to perform the requested procedure. The treatments you receive are voluntary and you knowingly release and hereby hold harmless the hair care professional/stylist/practitioner and Samel’s Beauty Lounge, LLC from any and all liability that may result from such treatment, including but not limited to: damages, loss, and/or injury and you assume full responsibility thereof. Furthermore, you acknowledge that, prior to any treatment being performed, you have had ample opportunity to discuss with Samel’s Beauty Lounge, LLC the treatment to be performed, and products to be used, and address any other concerns.