Color Correction Form *

First Name

Last Name

Phone

(###)

###

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Hair color history for the past two years.

Please check all that apply

Box dye at home?

Henna

Sun-in?

Have you gone from light to dark with your hair color?

Permanent wave (perm)?

Brazilian Blowout or Smoothing treatments?

Surgeries or general anesthesia?

Medications that could affect hair color (thyroid medication, chemotherapy, hormone therapy, Accutane)?

Hair Color Correction risks

Please check each box, that you have acknowledged the risks.

further compromising the integrity of the hair

colors fade quicker and you may have to come in sooner during the transition period

often there are multiple processing times, plan on it being a long day!

depending on the level of work needed, corrective color can be very expensive

multiple team members may work on your hair to be as efficient as possible

it may take multiple appointments to get to desired look and or tone

if you do not use professional hair care product, we will not and cannot guarantee the quality and longevity of your hair condition.