Hair Perm Consultation & Medical Consent Form

Client Information

Full Name *

Date of birth

Phone number *

Email Address *

Emergency Contact Name & Number:

Medical & Hair History

Sensitive scalp or allergies?

Yes

No

Pregnant or breastfeeding?

Yes

No

Recent bleach/colour?

Yes

No

Previous perm reaction?

Yes

No

Consultation Notes (Stylist Use)

Hair Condition:

Rod Size:

Products Used:

Patch Test Result:

Client Consent & Salon Policy

I confirm that I have provided accurate medical and hair history information. I understand that chemical or heat-based hair services may cause dryness, breakage, colour change, or allergic reaction depending on hair condition and previous treatments. I acknowledge that Garden of Eden Hair and Beauty cannot guarantee specific results and will not be held responsible for damage where professional consultation and procedures have been followed. All services are non-refundable once started or completed. I agree to follow aftercare advice and give full consent for the service to be carried out.

Client Signature:

Clear

Date

Stylist Signature:

Clear

Date

Hair Keratin Treatment Consultation & Medical Consent Form

Client Information

Full Name *

Date of Birth:

Phone Number: *

Email Address: *

Emergency Contact Name & Number:

Medical & Hair History

Sensitive skin or scalp?

Yes

No

Asthma or fume sensitivity?

Yes

No

Recent bleaching?

Yes

No

Previous keratin reaction?

Yes

No

Consultation Notes (Stylist Use)

Hair Condition:

Product Brand:

Heat Temperature:

Patch Test Result:

Client Consent & Salon Policy

I confirm that I have provided accurate medical and hair history information. I understand that chemical or heat-based hair services may cause dryness, breakage, colour change, or allergic reaction depending on hair condition and previous treatments. I acknowledge that Garden of Eden Hair and Beauty cannot guarantee specific results and will not be held responsible for damage where professional consultation and procedures have been followed. All services are non-refundable once started or completed. I agree to follow aftercare advice and give full consent for the service to be carried out.

Client Signature:

Clear

Date:

Stylist Signature:

Clear

Date:

Hair Colour Consultation & Medical Consent Form

Client Information

Full Name: *

Date of birth:

Phone number: *

Email address: *

Emergency Contact Name & Number:

Medical & Hair History

Allergies to hair dye?

Yes

No

Sensitive scalp?

Yes

No

Pregnant or breastfeeding?

Yes

No

Previous colour reaction?

Yes

No

Consultation Notes (Stylist Use)

Colour Formula:

Developer Strength:

Processing Time:

Skin Test Date:

Client Consent & Salon Policy

I confirm that I have provided accurate medical and hair history information. I understand that chemical or heat-based hair services may cause dryness, breakage, colour change, or allergic reaction depending on hair condition and previous treatments. I acknowledge that Garden of Eden Hair and Beauty cannot guarantee specific results and will not be held responsible for damage where professional consultation and procedures have been followed. All services are non-refundable once started or completed. I agree to follow aftercare advice and give full consent for the service to be carried out.

Client Signature:

Clear

Date:

Stylist Signature:

Clear

Date:

Hair Extensions Consultation & Medical Consent Form

Client Information

Full Name: *

Date of birth:

Phone Number: *

Email Address: *

Emergency Contact Name & Number:

Medical & Hair History

Hair loss or scalp condition?

Yes

No

Allergies to adhesive or metal?

Yes

No

Sensitive scalp?

Yes

No

Previous extension damage?

Yes

No

Consultation Notes (Stylist Use)

Extension Type:

Length/Colour:

Maintenance Advice Given:

Fitting Method:

Client Consent and Salon Policy

I confirm that I have provided accurate medical and hair history information. I understand that chemical or heat-based hair services may cause dryness, breakage, colour change, or allergic reaction depending on hair condition and previous treatments. I acknowledge that Garden of Eden Hair and Beauty cannot guarantee specific results and will not be held responsible for damage where professional consultation and procedures have been followed. All services are non-refundable once started or completed. I agree to follow aftercare advice and give full consent for the service to be carried out.

Client Signature:

Clear

Date:

Stylist Signature:

Clear

Date:

Hair Botox / Nanoplasty Consultation & Medical Consent Form

Client Information

Full Name *

Date of Birth

Phone Number *

Email Address *

Emergency Contact Name & Number:

Medical & Hair History

Sensitive skin or scalp?

Yes

No

Asthma or sensitivity to fumes?

Yes

No

Recent chemical services?

Yes

No

Previous smoothing reaction?

Yes

No

Consultation Notes (Stylist Use)

Product Used:

Heat Temperature:

Hair Condition:

Patch Test Result:

Client Consent and Salon Policy

I confirm that I have provided accurate medical and hair history information. I understand that chemical or heat-based hair services may cause dryness, breakage, colour change, or allergic reaction depending on hair condition and previous treatments. I acknowledge that Garden of Eden Hair and Beauty cannot guarantee specific results and will not be held responsible for damage where professional consultation and procedures have been followed. All services are non-refundable once started or completed. I agree to follow aftercare advice and give full consent for the service to be carried out.

Client Signature:

Clear

Date

Stylist Signature:

Clear

Date

Terms and Conditions *

I agree to the Terms and Conditions.

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Hair Perm Consultation & Medical Consent Form

Hair Keratin Treatment Consultation & Medical Consent Form

Hair Colour Consultation & Medical Consent Form

Hair Extensions Consultation & Medical Consent Form

Hair Botox / Nanoplasty Consultation & Medical Consent Form

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