Client Waxing Consent

1
Name
First Name
Last Name
2
Phone Number
Area Code
Phone Number
3
Email
example@example.com
4
Have you used any Alpha Hydroxy Acid (AHA) or glycolic products in the past 48-72 hours?
Yes
No
5
Are you using Retin-a, Renova or Accutane (an oral form of Retin-a)?
Yes
No
6
Are you using any other skin thinning products and/or drugs?
Yes
No
7
Are you exposed to the sun on a daily basis or are you considering spending more time in the sun soon?
Yes
No
8
Do you use a tanning bed?
Yes
No
9
Are you diabetic?
Yes
No
10
Are you currently taking medications? If so, please list all (including over the counter drugs/herbal supplements):
11
What skin products do you regularly use on your skin?
12
Have you ever been treated for cancer? If yes, when and what types of therapies were used?
13
Please list any other illness/condition you are currently being treated for by a medical professional
14
Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc.

I have read the above information and if I have any concerns, I will address these with my skin therapist. I give permission to my therapist to perform the waxing procedure we have discussed and will hold her and her staff harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

I have read and understand the post-treatment home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding my treatment or suggested home product / post-treatment care, I will consult the esthetician immediately.

I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.
15
Date
Date
Month
Day
Year
16
Signature
Clear
17

WHAT SHOULD I EXPECT?

PREP

Don't worry about trimming any hair!

We've got you covered. The ideal length is a grain of rice. No worries if it is longer. If you are a frequent shaver, wait approximately three weeks before coming in. Once the hair is at the perfect length, you are finally ready to book your appointment!

Health and Wellness

Please be aware of any adverse reactions due to any medications, medical conditions, or treatments you may be currently receiving. Certain skincare products can also affect your results. Products to avoid using about a week prior to scheduled appointment: Retinol, AHA, glycolic acid, salicylic acid, certain scrubs, etc. Please check with your doctor if you are uncertain if you are able receive a wax.

Day of

Please prepare by coming in clean and exfoliate a couple days prior to appointment. We highly recommend exfoliating gloves with a gentle body wash. You can take a pain reliever 30 minutes prior, just make sure you avoid ones with caffeine. You can also apply numbing cream before coming in.

What about your period?

You are welcome to still come into your scheduled appointment, but it is not recommended. The skin can be sensitive around your time of the month. If you decide to come in, please come in with a clean tampon and let's make sure we schedule your next visit at a different time!

AFTERCARE

So now what?

Make sure to avoid sexual activity, ill fitting clothing, suntanning, excessive heat or sweating, open bodies of water, hot tubs, pools, saunas, etc. for atleast 48 hours.

Between appointments

Please allow a few waxing appointments to see the full benefits of waxing. This is a commitment to not shave, trim or tweeze. This allows the hair to sync up on the same growth cycle and be as fine and as sparse as possible. Starting a few days after your appointment, it is important to exfoliate (2-3x week) and moisturize daily with the appropriate products to avoid ingrown hairs.
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