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First Name *
Last Name *
How did you hear about us
Friend / relativeSocial mediaGoogle searchStaying at the hotel / Walk in
Others Please Specify
Would you allow for us to take a video of your hair transformation for marketing purposes?*
YesYes, but without showing my faceNo
The procedure necessary to treat conditions have been explained to me, and I understand the nature of the procedure. I consent to the administration of needed and added work when necessary in connection with the applied procedure.
Risks and Complications resulting from procedures and treatments are included but not limited to the following: discomfort, infection, allergy, hair damage and/or burning, bleeding, etc....
Sensitive skin: a soft tissue reaction to the treatment which includes redness of tissue: as well complications related can include pain, swelling, bruising, infection, an unexpected allergic reaction.
I understand that during the treatment I may discover other unforeseen conditions that may require different procedures than those planned. I have been given the opportunity to ask as many questions regarding the nature, purpose and cost of treatment and have received answers to my satisfaction. I authorize her/him to perform such procedures that are deemed necessary in their professional judgment.
I understand that no guaranteed results have been offered or promised, and I give my free and voluntary consent for treatments and procedures.
I have a full understanding regarding the prices and the cost of the procedures via the salon staff, the company website and/or through any other friend or third party.
I CERTIFY THAT I HAVE READ AND/OR HAVE HAD THIS CONSENT LETTER EXPLAINED TO ME AND FULLY UNDERSTAND THE TERMS WITHIN THE ABOVE CONSENT AND VOLUNTARY GIVE MY CONSENT TO THE PROCEDURES.
Terms & Condition*
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