Hair Colour Skin Patch Test

RKW Hair will provide a 5 to 10 minute consultation which we can go through your treatment needs I will also take a patch test which is all part of this serivce.

The below form must be agreed & signed before all colours.

Angela Williams – RKW Hair


      Hair Colour Skin Patch Test Form

      Date (required)

      Name (required)

      Number (required)



      Postcode (required)

      Email Address (required)

      Telephone Number (required)

      - I am aware and understand that receiving any hair colour service can, in some individuals, cause an allergic reaction.

      - I fully understand that this reaction can occur at anytime even if I have received this service on previous occasions.

      - I further understand that is RKW Hair, policy to perform a skin patch test forty-eight (48) hours prior to all colour services.

      - I also understand that a negative skin batch test does not mean that a reaction will not still occur.

      - I understand these risks and if I have any concerns I will seek medical advice prior to any colour service.

      - Further, I grant RKW Hair permission to colour my hair and not hold them responsible for any, and all adverse health reactions from this service.

      I have read and understand the statements noted above *
      YES I understand and accept this statement.

      I accept a patch test * (required)
      YES I understand and accept this statement.

      Area of Patch Test: (RKW Hair to complete)

      Patch Test Result: (RKW Hair to complete)

      Customer Signature

      RKW Hair Signature (Angela Williams)

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