Name *

First Name

Last Name

Phone *

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I have been made aware by cosmetologist, Kia Yang, that I am choosing to have a chemical service done to my hair. *

Please check all boxes after reading and understanding all liabilities listed below.

Hair History (I): I have made my stylist aware of all the services and products I have used and/or I have done, or another stylist has used/done to my hair. I understand that withholding information can negatively affect the outcome of your color service. I realize that this is extremely important information and if I withhold any information this may lead to damage to my hair and an unpredictable chemical reaction in the process.

Hair History (II): I understand that the use of box dye or unprofessional hair dye can cause more damage to my hair as we proceed with a hair lightening service today. I understand that using such products on my hair previously will hinder my stylist from achieving certain results.

Hair Maintenance + Hair Care (I): I have been aware of the process I will need to go through during this service including maintenance in the following months. I understand that high lift blondes and vivid colors are damaging and will require a lot of maintenance and upkeep. I understand that I will need to use proper shampoo, conditioner, and hair treatments. Lack of using proper hair care or recommended hair care may result in color fading faster than normal.

Hair Maintenance + Hair Care (II): I understand that proper hair care will help my hair color last longer. However I have been informed that even with proper hair care, because of the damage that has been done, hair color will fade faster and will only usually last for a month to a month and a half.

Hair Damage: I also understand that this current chemical hair service being performed by Kia Yang may also cause little to extreme damage to my hair. I have been made fully aware of the hair damage and hair loss that can ensue during and after this process and am still fully giving consent to continue with this service.

Adjustments + Refunds (I): Any hair color adjustments can be made within a 2 week timeframe from the date that this waiver is signed. These adjustments made within a 2 week timeframe are complimentary.

Adjustments + Refunds (II): A partial refund of the price paid on the day of the service can be made after a 2 week timeframe. The initial deposit at the time of booking is non-refundable.

Date *

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