WAXING - INFORMATION AND CONSENT

Name

DOB:

Date

PLEASE ANSWER THE FOLLOWING:

Rows	YES	NO
Have you used any exfoliating acids, retinol, or active skincare products in the past 3–5 days?
Have you recently had a chemical peel, laser treatment, or used strong exfoliating products?
Are you currently using Accutane, prescription acne medications, antibiotics, or any medications/products that may increase skin sensitivity?

Please list all current medications, including antibiotics, prescription acne medications, Accutane, hormones, steroids, supplements, and over-the-counter medications.

Have you ever been treated for cancer? If yes, when and what types of therapies were used?

Please list any other illness/condition you are currently being treated for by a medical professional

Photographs: I give permission for photographs to be used by Viso Bello Spa for educational plus promotional purposes. Complete patient confidentiality will be maintained at all times. Please initial if accepted:

Initial here

Please note that skin may be more sensitive during or around your menstrual cycle, which can make waxing feel more uncomfortable.

Waxing may cause temporary redness, swelling, tenderness, sensitivity, or in rare cases, skin lifting. I have disclosed any known allergies, medications, skin products, or medical conditions that may affect my treatment. I understand that certain medications and skincare products may increase skin sensitivity.

I understand that my esthetician will take every precaution to minimize irritation and that following proper aftercare recommendations is important for best results. I have had the opportunity to ask questions, understand the treatment being performed, and consent to receiving waxing services today.

Client Name (printed)

Client Name (signature)

Date