Waxing Consent Form

Customer Name

First NameLast Name

Customer Email

example@example.com

Customer Phone Number

Please enter a valid phone number.

Age

Gender

Please answer the health and skin checker for the safety of the procedure:

	Yes	No	Remarks
Have you done any waxing before?
Are you currently taking/using any skin thinning/exfoliating treatments or medications? (If yes inform your service provider as, you can NOT be waxed today).
Do you have skin allergies?
Do you have any communicable diseases or sexually transmitted diseases?

Are you currently using any cosmetic products on the area being waxed or internally that may contain the following substance? These are a contraindication and you will not be able to be waxed today. Kindly check if yes and if no, leave it blank.

I am providing my consent to complete the procedure I am requesting. I am duly aware of the possible side effects of waxing during or after the procedure such as swelling, irritation, bruises, or bumps. The hair removal process has been throughly explain to me and I have had an opportunity to ask questions and have received satisfactory answers. I understand GlowUp Skin Spa LLC has advised me that the service requested may cause lifting of the skin and possible bleeding, have unpredictable results or cause adverse reactions from allergies I did not communicate with them.

I acknowledge and completed the health and skin checker, efficiently, and accurately.

I agree to assume the risk of any adverse reactions, injury or damage that I might suffer because of such negligence or carelessness. I agree to give up my right to sue the operator, spa, and any other personnel for any such reaction, injury, or damage. I have carefully read this agreement. I fully understand that it is a release of liability and I sign this on my own free will.

I acknowledge that I must adhere to GlowUp Skin Spa's policies. I understand that cancellations must be done with at least 24 hours notice. Failure to do so will result in 50% of the total service cost. I acknowledge that ANY no show will result in 50% of the total service cost. I understand that after 15 minutes of tardiness my appointment may be subject to cancellation and I will be responsible in accordance with the “ No-show” policy.

I hereby affirm that I have read and fully understand the above, am eighteen years of age or older (or this form must be filled out by a parent/legal gaurdian) and am legally liable for my own decisions/actions.

By signing below, it means that I agreed to the terms indicated in this document.

Customer Signature

Date Signed

Date

Waxing Consent Form

Waiver Consent