Hair Extension Bead Application Consent Form
Please read carefully and provide your consent for the hair extension bead application procedure.
Client Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Have you had any allergic reactions to hair products or adhesives before?
*
Option 1
Option 2
Option 3
Do you have any scalp conditions or sensitivities?
*
Option 1
Option 2
Option 3
Client Signature
*
Submit
Should be Empty: