Hair Model Client Form — Dinah Lefranc

Client Information

Full Name *

Phone Number *

Email Address *

Instagram Handle

Date of Birth *

Emergency Contact Name & Number *

Location *

Appointment Information

Date of Appointment *

Requested Service *

Model Call / Event Name

Hair Stylist

Hair Photos

Please attach clear photos of your current hair (front, side, and back views).

Upload Hair Photos

Photo angles included

Front View Side View Back View

Style Flexibility

Are you comfortable with doing different styles, colors, or cuts with your hair?

Yes, I am open to different styles, color changes, and cuts. I am open to styles only. I am open to color services only. I am open to cuts only. No, I am not comfortable with major changes.

Hair Preferences

Please let us know what you would NOT like for your hair.

Hair History

Previous Chemical Services (within the last 12 months)

Hair Color Highlights Relaxer Keratin Treatment Perm Bleach Service No Chemical Services

Hair Concerns

Breakage Dryness Hair Loss / Thinning Scalp Irritation Split Ends Damage from Heat No Concerns

Model Participation Agreement

Please initial each statement to confirm you understand and agree.

I understand that I am volunteering as a hair model.

I understand that results may vary and no guarantees have been made regarding the final outcome.

I understand that photos and/or videos may be taken before, during, and after the service.

I give permission for my photos/videos to be used for educational, promotional, marketing, and social media purposes.

I understand that services performed during model calls may take longer than standard salon appointments.

I have disclosed all known hair treatments, allergies, and scalp conditions.

I understand that if I experience discomfort or irritation, I should notify the stylist immediately.

Photo & Media Release

YES, I authorize the use of my photos/videos for social media, marketing, education, and promotional materials. NO, I do not authorize the use of my photos/videos.

Liability Waiver

I acknowledge that I am voluntarily participating as a hair model and release the stylist, salon, educator, and affiliated brands from liability related to services performed, except in cases of gross negligence.

I have read and agree to the liability waiver above. *

Yes, I agree.

Additional Notes

Signature

Client Signature (type full name) *

Date *