• Consultation

    Pre-appointment requirement. This form MUST be completed prior to appointment.

  • ANY INFORMATION GIVEN WILL REMAIN PRIVATE AND CONFIDENTIAL

    HAIR COLOURANTS CAN CAUSE AN ALLERGIC REACTION WHICH IN CERTAIN CASES MAY BE SEVERE. THEREFORE, TO HELP REDUCE THE RISK OF AN ALLERGIC REACTION, IT IS ESSENTIAL TO FOLLOW THE PRECAUTIONS BELOW:

    Every new colour client should receive an initial Allergy Alert Test prior to receiving their first colour service. This is to be repeated every 12 months, at a minimum.

    To decide if any further Allergy Alert Tests are required prior to a follow-up colour service, I must ask you the following protocal questions that appear on the Professional Safety Evaluation and make a note of the results.

    However, it is extremely important that you always bear in mind that no test or protocol can provide a 100% guarantee that you will avoid any future allergic reactions.

  • Client Details

  • I am over 18:*
  • Clear
  • What service are you looking to book?
  • Do you have a preferred time?
  • What are your Hair Goals?
  • What is your current hair status?

  • Hair History

  • What is the current length of your natural hair?
  • What is the main colour of your hair that you have at the moment?
  • What is your NATURAL colour?
  • What is the density of your hair?
  • What is your hair texture?
  • What condition is your hair currently in?
  • What is the current condition of your scalp?
  • How often do you wash your hair?

  • Professional Safety Evaluation Protocals

  • Have you ever had an allergic reaction to hair colourant products?*
  • Have you ever had a reaction to a temporary ‘black henna’ tattoo, any other type of skin tattoo or permanent make-up?*
  • Does you currently have a rash on your face or an irritated and damaged scalp?*
  • Have you regularly colour your hair?*
  • Are you a new colour client OR are you wanting to change your colour shade?*
  • Has it been more than 12 months since your last allergy test?*
  • Have you had any type of an allergic reaction since your last colour appointment with Anna?*

  • Acknowledgement & Consent

    • 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 at any time, even if I have received the same service on previous occasions. 
    • I further understand that it is Anna Marie's policy to perform an Allergy Alert Test 48hrs prior to your colour service and to follow manufacturers protocals.
    • I also understand that a Negative patch test result does NOT mean/guarantee that a reaction may not occur.
    • I understand these risks and if I have any concerns, I will seek medical advice prior to any colouring services.
    • Further, I grant permission to Anna Marie's to colour my hair and not hold them responsible for any adverse health conditions that may occur.
    • I confirm that all the information given by me is true and accurate to my knowledge at the time.
    • By signing below, you agree that you have read and understood the terms and agreement above.

    ALL information provided will remain PRIVATE & CONFIDENTIAL.

  • Clear
  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year
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  • Website: www.annamarieshair.weebly.com

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