CLIENT NAME
CONTACT
NUMBER
EMAIL
AGE GROUP: 18-20
EXPERT’S NAME
SCALP NORMAL OILY DRY DANDRUFF SENSITIV HAIRLOSS
CONDITION E FROM ROOTS
HAIR TEXTURE WAVY CURLY STRAIGHT
HAIR DENSITY FINE MEDUIM THICK
HAIR HEALTHY DRY SENSITISED
CONDITION
HAIR HEALTHY WEAK
ELASTICITY
PAST
HAIR HISTORY DETAILS 1-3 3-6 MONTHS 6-12
MONTH MONTHS
S
HAIR IS VIRGIN
HENNA
CONSUMER COLOUR PACKS
METALLIC DYE
BLACK SHAMPOO
HERBAL PACKS
PROFESSIONAL GLOBAL COLOUR/ROOT
TOUCH UP/HILITES
KERATINE
CYSTEINE / QOD
STRAIGHTENING/SMOTHENING/
NUTRISMOOTH
PERMING
PRESENT
NATURAL BASE
% OF GREY
HOME CARE (SHAMPOO & CONDITIONER)
FREQUENCY OF SHAMPOOING
SERUM/STYLING PRODUCT
OILING (FREQUENCY & TYPE OF OIL)
FUTURE
DESIRED RESULT
FRIZZ FREE SMOOTH & SHINY HAIR – CYSTEINE
FRIZZ FREE SMOOTH, SHINY HAIR & REPAIR DAMAGE – MAX PRIME QOD
FRIZZ FREE SMOOTH, SHINE & POKER STRAIGHT HAIR – STRAIGHT GLOSS
THERAPY
FRIZZ FREE SMOOTH, SHINE & POKER STRAIGHT HAIR – GLATT REBONDING
FRIZZ FREE SMOOTH, SHINE & NATURAL STRAIGHT HAIR – GLATT SMOOTHNING
DECLARATION
I AGREE & CONFIRM THAT
CYSTEINE SERVICE
Result will last upto 36-40 washes but as per my post care
Additional benefit – Hair will relax/flat look 30% & last depending on hair type & homecare regime
During cysteine service there may be variation in hair colour level
For best results in repair 2-3 sitting required within 25 days gap
Use of sulphate free shampoo & conditioner is mandatory
If I don’t follow protocol of post care , result may vary
MAX PRIME QOD SERVICE
Result will last upto 50-55 washes
Additional benefit – Hair will relax/flat look 60% & last depending on hair type & homecare regime
During QOD service there may be variation in hair colour level
For best results in repair 2-3 sitting required within 25 days gap
Use of sulphate free shampoo & conditioner is mandatory
SMOOTHENING / REBONDING / STRAIGHT GLOSS THERAPY
Due to heena coating results may vary
Colour cannot be done post texture service till 25 days & after colour gap of 10 days is required to do this service
6-8 months gap before going for regrowth
Smoothening is not straightening, there are likely to be some waves in the hair
Hair cannot be tucked, tied or clipped for 48 hours post texture service
Avoid water contact with hair for 48 hours post texture service
Avoid travel in sun as humidity would cause perspiration & will result waves in the hair
For longevity of texture service undergo spa treatment once in 3 weeks
Use of shampoo & conditioner specially designed post texture service
CONTRAINDICATIONS: PLEASE READ CAREFULLY
AFTER CYSTEINE/ QOD CANNOT DO STRAIGHTENING.
CHEMICAL SERVICES CANNOT BE DONE ON PERSON SUFFERING FROM ASTHAMA, HIGH BLOOD PRESSURE, PREGNANT
WOMEN, FEEDING MOTHERS, PERSON UNDERGOING CHEMOTHERAPY, PERSON SUFFERING FROM EXCEPTIONAL HAIR
LOSS, INFECTION ON SCALP, ALOEPICIA OR ANY SPECIFIC ALLERGY PRONE.
I HAVE RECEIVED CONSULTATION REGARDING THE NATURE OF PROCEDURE THAT WILL BE FOLLOWED TO COMPLETE
THE SERVICE.
I HAVE BEEN INFORMED ABOUT THE COST OF SERVICE BEFORE AVAILING IT.
I HAVE UNDERSTOOD THE PROCDURE, CONTENT, BENEFITS & AFTER CARE OF THE SERVICE & EXPECTED VARIABLE
RESULTS FROM THE SERVICE.
IN CASE OF ANY NON-DISCLOSURE FROM MY END PRETAINING TO ANY FACTS, I AGREE NOT TO HOLD THE
CONSULTANT/SALON/SALON REPRESENTATIVE/STYLIST OR LAKME LEVER PVT LTD FOR IT’S CONSEQUENCES.
THE PERSONAL & SENSITIVE PERSONAL INFORMATION PROVIDED IN THIS FORM IS OUT OF MY FREE CONSENT TO
ENABLE THE COMPANY TO CARRY OUT THE ABOVE-MENTIONED SERVICES.I, FURTHER AGREE THAT THE COMPANY
MAY STORE THE SAME FOR FURTURE REFERNCE & USE FOR PROVIDING & RECOMMENDING ME SUCH SIMILAR HAIR
SERVICES.
EXPERT NAME: _______________ SALON MANAGER’S NAME: ________________________ CLIENT NAME: ___________________
EXPERT SIGN: ________________ SALON MANAGER’S SIGN : _________________________ CLIENT SIGN: ____________________
