Keratin Treatment/Brazilian Blowout Release Form
Email address *
Name *
Your answer
Phone *
Your answer
Hair Type/Texture *
Your answer
Color History *
Your answer
Type of Color (check all that apply) *
Required
Last Highlight or Bleach Service *
Your answer
Have you had your hair relaxed or smoothed with chemicals? If so, how many have you done and when was your last service? *
Your answer
What are your expectations from your Keratin Treatment? *
Your answer
Lifestyle/Day-to-Day Activities (i.e. hot styling tools, styling products, workout, swimming, etc.) *
Your answer
Are you pregnant? *
Do you have any allergies or medical conditions? *
Your answer
*
Required
*
Required
*
Required
*
Required
By typing my name below I acknowledge that I have provided honest answers, and that I read and understand the waiver and liability release. *
Your answer
*
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service