A brief web search produced a headshot photographer in LA who uses two forms:
http://www.fredjohnson.net/page1/page2/page2.html
"Before the hair/makeup artist takes over, you will be required to read and sign two forms -- a standard model release and a usage license agreement. These are standard contracts that basically say that (1) the photographer owns the copyright and (2) the model has the right to reproduce the photos for promotional purposes. You may print these out and bring them with you. Please notify us ahead of time if you decline to sign the model release."