Colour & Chemical Service Consent
Patch test confirmed, history declared, risks acknowledged, and signed.
6 questions · 1 page · about 3 minutes to answer · fully editable after you start
Chemical services carry real risks that documentation must precede: allergic reactions, condition damage on compromised hair, results limited by history the client forgot to mention. This consent form does the protocol properly – patch test confirmation with date, full history declaration, risk acknowledgements item by item, and the signed record.
Insurers increasingly expect exactly this record; salons keeping it per service protect the client first and the business immediately after.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
Opens in the Light theme, or in your own default theme if you have set one — change it anytime to any of the 4 built-in looks, or build your own on a paid plan.
Page 1
Before your colour service
This form records that you have been told about your colour or chemical service and agree to go ahead. Please read each statement and tell your stylist about anything that might affect the treatment. It takes about 3 minutes.
Q1.Client name and today's service*
Q2.Patch test status*
- Done 48+ hours ago, no reaction
- Done - mild reaction (discuss first)
- Not done - needs one before service
Q3.Declare ALL chemical services and colorants in the past 2 years (including home products)*
Q4.Acknowledgements*
| Acknowledged | Question first | |
|---|---|---|
| Results vary with hair history and condition | ||
| Allergic reactions are possible despite testing | ||
| Aftercare instructions affect the result's life | ||
| Undeclared history may compromise the result |
Q5.Date*
Q6.Client signature*
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