NEW CLIENT WELCOME FORM Personal Information Birthdate Personal Information Client Referral For each new client you refer, we will send you a complimentary service! 48 HOUR CHEMICAL TEST Bon Vivant Salon and manufacturers of the products used for chemical services recommend a "patch test" be given 48 hours prior to receiving chemical services to determine allergic or adverse reactions to the chemicals used in some of the services we provide. [radio* HOURCHEMICALTEST use_label_element default:1 "I want to receive a test patch and schedule services 48 hours pending no reaction." "I do not want a patch test, releasing Bon Vivant Salon and manufacturers from liability."] WAXING RELEASE Due to the reactions some medications and topical treatments may have on the skin, Bon Vivant Salon recommends discussing with your doctor before receiving any waxing services. The following is a non-inclusive list of known medications that react to waxing services. Please advise your stylist if you are currently using any of the following: Accutane (within the past year)Retin A (within the past 2 weeks)Glycolics (within the past 2 weeks)Retinal (within the past 2 weeks)AHAs / BHAs (within the past 2 weeks)SteroidsBlood ThinnersAntibiotics RECENT HORMONE CHANGES Hormone changes can affect how your hair reacts to color. MedicationsHair LossFragile HairHistory of Coloring Difficulties QUICK CHANGE Smocks are available and should be worn when receiving services. Bon Vivant Salon will not be responsible for loss or chemical reactions to the skin or personal effects of any kind. CUSTOMER SATISFACTION We do not give cash refunds. If you are dissatisfied, return to Bon Vivant Salon within two weeks of your service and we will provide the services to insure your satisfaction. AGREEMENT I have read and agree to all the information on this form. 84523