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Underground Beauty Salon Suites

Client intake & chemical service consent

Please answer honestly and completely. This helps your beauty professional decide whether the service you requested is right for your hair and scalp. It takes about three minutes.

About you

Today’s service

Hair & scalp history

Have you experienced any of the following? Check all that apply.
Have you had a chemical service in the last 12 months?

Allergies & sensitivities

Any known allergies or sensitivities to hair products, adhesives, latex, color, bleach, relaxers or fragrances?
Are you using medications or topical products that may affect your hair, scalp, skin sensitivity or healing?

You are not required to share unrelated private medical information.

Chemical services may include hair color, bleach or lightener, highlights, relaxers, texturizers, keratin and smoothing treatments, corrective color and other chemical processes. These services carry risks and individual results vary. Possible risks include:

  • Hair dryness or brittleness
  • Hair breakage or shedding
  • Changes in curl pattern or texture
  • Uneven or unexpected color results
  • Scalp or skin irritation
  • Allergic or sensitivity reactions
  • Chemical burns
  • Temporary or permanent hair damage
  • Need for additional treatments or corrective services

Previous chemical services, home treatments, medications, extensions, heat damage and incomplete hair history can all affect your result. Your stylist may refuse, modify, postpone or stop a service if she believes continuing could create an unreasonable risk of damage or injury.

Signature

Type your full name below as your signature. Today’s date is recorded automatically.

Signed 2026-09-23