client intake form barber

Professional Barber Services Intake and Liability Waiver

Instructions for Use

• Complete all sections of this form accurately, ensuring that the Client provides current contact information and discloses all relevant health or skin sensitivities.
• Retain a signed copy of this document in the Client’s permanent file for a minimum of three (3) years or as required by local record-keeping regulations.
• Review the health disclosures with the Client verbally prior to the commencement of any services to ensure mutual understanding of potential contraindications.

Parties & Definitions

This Agreement is entered into between [Barbershop Name] ("Service Provider") and [Client Full Legal Name] ("Client"), residing at [Client Address], on this [Day] day of [Month], [Year].

Operative Terms

1. Service Consent: The Client hereby requests and consents to the barbering services to be performed, including, but not limited to, hair cutting, shaving, trimming, and grooming.
2. Health Disclosure: The Client represents that they do not have any skin conditions, allergies, or infectious diseases (including but not limited to open wounds, rashes, or communicable skin disorders) that would interfere with the safe performance of services.
   • No known conditions
   • Known conditions: [__________]
3. Assumption of Risk: The Client acknowledges that barbering services involve the use of sharp instruments and chemical products. The Client voluntarily assumes all risks associated with the services provided.
4. Liability Waiver: To the fullest extent permitted by law, the Client releases the Service Provider, its employees, and agents from any and all liability, claims, or demands arising out of or related to any loss, damage, or injury that may be sustained by the Client during or as a result of the services, except in cases of gross negligence or willful misconduct.
5. Right to Refuse Service: The Service Provider reserves the right to refuse service to any individual who appears to be under the influence of substances, exhibits aggressive behavior, or presents a health risk to the staff or other patrons.
6. Cancellation Policy: The Client agrees to provide at least [Number] hours' notice for cancellations. Failure to provide notice may result in a fee of [Currency Amount].
7. Governing Law: This document shall be governed by the laws of the state/province of [State/Province].

Acknowledgment

By signing below, I certify that I have read this document in its entirety, understand its contents, and agree to be bound by its terms.

Signature: __________

Printed Name: [Client Full Legal Name]

Title: [Client or Guardian]

Date: [Date]

Legal Disclaimer: This document is a general framework for informational purposes only and does not constitute legal advice. You must consult with qualified legal counsel in your specific jurisdiction to ensure compliance with local health codes, consumer protection laws, and liability regulations.