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Patch test release form

Let us do this part
Today's Date:
Mon Dec 2 2024 04:58
Practitioner:*
Please read and answer
I have applied a skin test for my treatment at Milly's Beauty Bar*
I agree to contact Millys Beauty Bar immediatly if I have any reaction to my skin test*
A patch test is performed to cover you and us incase of a reaction. Thank you for taking the time to follow such an important procedure.

Milly and the girls <3
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Name:*
Address:
Postcode:
Date of birth:*
If you are under 18 your parent/guardian will be required
Phone #:*
Email:*
Signature:*