Chemical Service Consent and Liability Waiver

 

Nie Studio LLC.

2957 Battleground Av

Greensboro, NC 27408

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Client Full Name: _________________

Date: _________

         

          I, _________the above named client request a chemical service to be performed by the above noted Nie Studio, LLC licensed stylist at ____________the above noted address.

            For purposes of this consent and waiver, a chemical service is any salon service that requires the application of products which may contain chemicals, which include but are not limited to those used in hair color, bleach, perm, Keratin Complex Treatment, Brazilian Blowout, Thermal Reconditioning, and/or Japanese Thermal Hair Straightening. 

 

            I understand that the darker the hair color initially is, the harder it will be to lift to an artificial blonde, silver, or gray color.  I have provided my stylist during consultation information regarding any medical conditions, sensitivities, allergies, medications, and/or prior services done to my hair to assist my stylist in their assessment of my hair.  Based upon my stylist skills and level of experience, she/he will try her/his best to lift the hair as light as it will (safely) take, and then tone and cover with lighter color, if needed.  Accordingly, it may require more than one or multiple visits to achieve the desired results.

 

            If the result color is not as light as I hope, I have the option of returning at a later date and have the service done again for the same price/less/or more depending on what I’m getting or hoping to achieve. I understand that Nie Studio, LLC will charge for their services at each session appointment, whether the desired color was achieved or not that day since the number of visits necessary to achieve the desired result cannot always be determined until the chemical process has been initiated.  Any satisfaction guarantee offered by Nie Studio, LLC does not apply to artificial blonde, silver, gray color since there are varying results based on different types and colors of hair. 

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          Cost for subsequent sessions is determined by the amount of work and products necessary to achieve the desired color.  Therefore, a strand test is recommended to preview the possible color results and test the hair to determine its suitability for the given chemical process. 

 

I would_____ I would not_____ like the strand test performed. 

 

          I understand that there are risks associated with a chemical service.  Specific risks will vary but at all times may result in personal injury, illness, permanent disability, death, and destruction, damage, or loss of property.

 

          A chemical service may cause discomfort to the scalp and/or hairline area.  While mild discomforts are common and it is my duty, as the client, to inform my stylist if I am experiencing adverse reactions, which may include, but are not limited to generalized rashes, skin irritations, pain, stinging, burning sensation on the scalp, hairline, face, or neck, itchy swelling scalp or face, swelling of the throat and tongue, trouble breathing, or discomforts that becomes intolerable. These symptoms can occur even if there are no reactions to hair color products in the past.  If a reaction occurs during a chemical service, my stylist will rinse off all products immediately and thoroughly.

 

          I understand that a patch test is recommended prior to a chemical service to help determine whether I may be sensitive to the chemical formulas.  However, it does not guarantee that a reaction will not occur.  

 

          I would_____ I would not_____ like the patch test performed.  

 

          I understand that in the event of an emergency (i.e client has an adverse reaction), I authorize my stylist to call for medical assistance and be transported to a medical facility or hospital. I further agree that I will be responsible for all costs and expenses associated with any such medical care and/or related transport and hereby hold harmless and indemnify Nie Studio, LLC of any such costs.  

 

         I understand that chemical service may also damage my clothes and hair.  Bleach/lightener strips the hair of its protein and natural pigment.  The chemical process may make hair feel dry, brittle, or mushy with an increased chance of breakage.  The option of going back to a darker color is not possible within the first couple of weeks of bleaching.  Also, there will be more maintenance required such as deep conditioning, protein, and/or moisturizing treatments/bond perfector, and may require continued use of professional products to maintain the health and integrity of my hair. 

 

         I understand the risks of receiving a chemical service, which may result in personal injury, illness, permanent disability, death, and destruction, damage or loss of property, and consent to such service.  I understand that the risk may result from the actions, omissions, or negligence of myself and others, including but not limited to salon owners, partners, employees.  I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any personal injury, illness, permanent disability, death, and destruction, damage or loss of property or expense of any kind that I may incur in connection to receiving a chemical service from Nie Studio, LLC.  I hereby voluntarily and without duress agree to release, covenant not to sue, discharge, hold harmless, and indemnify Nie Studio, LLC, its owners, partners, employees, agents, and/or representatives of and from any present or future claims, demands, damages, costs or expenses of any kind arising out of or relating to receiving a chemical service.

 

By signing below, I agree I have read, understand, and accept the terms of this Chemical Service Consent and Liability Waiver.

 

 

Signature: ____________________                                  

 

Date: _________________