HAIR COLOUR SKIN PATCH TEST

Colour Consent and Waiver Form

(Must be Filled, Agreed and Signed before you come for a hair colour appointment)

Client Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency Contact Name

Emergency Contact Phone

Medical Conditions/Allergies

Current Medications

Hair Colour Service Agreement

I am aware and understand that receiving any hair colour service can, in some individuals, cause an allergic reaction.
I fully understand that this reaction can occur anytime, even if I have received this service on previous occasions.
I further understand that it is the A Star Beauty salon’s policy to perform a skin patch test forty-eight (48) hours prior to all colour services.
I also understand that a negative skin patch test does not mean that a reaction will not still occur.
I understand these risks and, if I have any concerns, I will seek medical advice prior to any colour service.
Further, I grant A Star Beauty permission to colour my hair and do not hold them responsible for any and all adverse health reactions from this service.

I Accept a Patch Test

Disclaimer and Consent

I am aware of the risks and benefits of salon procedures and provide my consent to participate

Client's Signature

Clear Signature

Today's Date