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Client Consent
Form

First name

Last name

Email

Items Discussed

Additional Thoughts/Concerns

Color Analysis

Select a date

Season *

Fall

Winter

Spring

Summer

Undertone *

Warm

Cool

Skin Complexion *

Fair Warm

Fair Cool

Neutral Warm

Neutral Cool

Golden Warm

Golden Cool

Pink Warm

Pink Cool

Olive Warm

Olive Cool

Tan Warm

Tan Cool

Dark Warm

Dark Cool

Deep Warm

Deep Cool

Eye Level *

Deep 2

Deep 3

Deep 4

Medium 5

Medium 6

Medium 7

Light 8

Light 9

Light 10

I consent to have my photo taken for documentation purposes.

I consent to my photo being used on social media.

Before Photo 1

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Inspo Pic 1

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Before Photo 2

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Inspo Pic 2

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Price Quoted

Any known allergies or sensitivities?

I have been offered a patch test before my service.

I understand that reactions, though rare, may include but are not limited to: redness, itching, swelling, blistering, or hair damage.

I am choosing to decline the patch test and understand that by waiving this option, I accept full responsibility for any allegic ractions or sensitivities that may occur.

At home care:

I understand my at home maintenance regimen and understand that if I don't follow my stylists recommendations for products and haircare, my service will not be guaranteed by Willow and Jade.

I understand it is my responsibility to find adequate parking during my salon visit.

I understand there are chemicals being used that may stain my clothing or personal items. I agree that Willow and Jade is not liable for damage to my personal property.

I have reviewed Willow and Jade's refund/service guarantee policy and agree to the terms.

Client Signature

Thanks for submitting!

1607 MAIN STREET

BELMAR, NJ 07719

INFO@WILLOWANDJADENJ.COM

Phone: 732-749-7733

Text: 732-592-9977

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