CLAUDIA'S BEAUTY YXE Waxing Consent Waiver

First & Last Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell

Email address

example@example.com

Do you agree to abide by the cancellation/late policy: STRICT 24hr cancellation notice required. 5 Minutes late is a cancellation. *No exceptions*. The deposit is taken at time of booking. This deposit is kept if you no show, cancel without 24hr notice or do not show up at appointment time. Address will be sent out via text 24hrs prior.

YesNo

If you are pregnant, brow lamination can not be performed. Brow waxing, henna and tinting may be an option but please consult with your physician prior to appointment. *More info in the paragraphs below.

I am pregnantI am not pregnant

Have you used any Alpha Hydroxy Acid (AHA) or glycolic products in the past 72 hrs?

YesNo

In the past 5-7 days, have you used any form of topical retinol? If yes, please immediately reschedule appointment and discontinue use 5 days prior to booking. Consult Claudia for any questions.

YesNo

Are you using any prescription drugs (topical or oral) to treat acne?

YesNo

Have you ever had an allergic reaction, irritation, or skin removal from waxing in the past?

YesNo

Have you ever had an allergic reaction/irritation to hair dye or eyebrow tinting/and or henna, or brow lamination in the past? If so please contact Claudia immediately.

YesNo

If you would like a patch test of the dye 48hrs prior to appointment to ensure there are no allergies check yes, otherwise check no to consent to omitting the patch test and continuing with appointment confirmation

Yes I would like a patch testNo I am omitting patch test

If you answered yes to either of the previous 2 questions, please detail what kind of reaction occurred.

Do you have any allergies? If so, please list below.

Are you currently taking medications? If so, please list all (including over the counter drugs/herbal supplements)

What skin products do you regularly use on your skin? Please be aware and avoid self tanning products if possible as it will cause the henna to turn darker than normal.

I understand that waxing, tinting, henna, and brow lamination services carry potential risks, including but not limited to: skin sensitivity, redness, swelling, tenderness, irritation, allergic reactions, and temporary or prolonged discomfort. I acknowledge that brow henna and tint may contain PPD (para-phenylenediamine), a known allergen, and accept the risk of a possible reaction.

Brow Lamination:I understand that brow lamination may not be suitable for everyone. Contraindications include, but are not limited to: pregnancy, skin conditions (such as eczema or psoriasis) around the brow area, recent cosmetic procedures, open wounds, sunburn, or severely sensitive skin. I confirm that none of these apply to me at this time. I acknowledge that brow lamination results typically last 4–8 weeks, with results varying by individual. There are no guarantees, and the procedure should not be repeated sooner than every 8–10+ weeks to maintain brow health.

I confirm that I have accurately disclosed all relevant health information, allergies, and any topical or oral medications. I release Claudia Oberg from any liability related to reactions or complications resulting from undisclosed medical conditions, skin sensitivities, or product interactions.

If I experience any adverse effects, I agree to follow my healthcare provider’s instructions. I understand Claudia will take all reasonable precautions to minimize risk and that I must follow proper aftercare to maintain results and reduce the chance of irritation or damage.

All concerns regarding the service outcome must be communicated within 72 hours to be eligible for a complimentary touch-up. Any issues raised after this window will be addressed at the next appointment. No refunds will be issued.

Unless otherwise discussed, I give consent for before, during, and after photos to be used for promotional purposes, including on social media and Claudia’s website.

By signing this waiver, I confirm that I have read, understood, and voluntarily agree to the terms above and consent to proceed with the discussed services.

I, Name Here* certify that I have read and consent to the above paragraphs, questions and procedure discussed in this waiver and policies. If you are under 18, parent consent and signature is needed.

Client Name (Signature)*

Date

If you know exactly what you want, please attach an image of your desired eyebrows.