• Stilus By Sorivel

    Stilus By Sorivel

    Client intake form

  • Customer Details:

     
  • Format: (000) 000-0000.
  • Do you have any allergies*
  • Are you currently taking any medication?.. If yes please list it below*
  • What is your hair type?*
  • How is your scalp?*

  • I __________, understand that an reaction during or after my hair treatment may occur. In acknowledgement of the foregoing, I hereby authorize Stilus By Sorivel LLC and its staff to perform hair services and hereby release Stilus By Sorivel LLC, its staff, officers, or its assigns, from any and all liability arising from or as a result of the hair services I will receive today and including all future appointments. I hereby assume full and complete responsibility for any personal injury, loss or damage to my health or property as a result of the hair services I will receive at Stilus By Sorivel today and including future appointments. Stilus By Sorivel LLC cannot and does not claim to diagnose or give advice on any medical conditions of the skin and/or otherwise. I agree to seek immediate medical attention and advice from a qualified physician or medical facility should any irritation or adverse reaction occur.  **** By signing your name below you agree and acknowledge to the waiver stated above*

  • Should be Empty: