BROW WAX/TINT CONSENT FORM

NAME

First NameLast Name

DATE OF BIRTH

PHONE NUMBER

Format: (000) 000-0000.

Have you ever had a reaction to a waxing service?

Do you use a glycolic acid, salicylic acid, lactic acid or any other acid-based products on your face?

Have you had a recent microdermabrasion, laser resurfacing or injectable fillers?

Are you taking acne medication or using vitamin-A products?

Have you or will you be in the sun or tanning bed within 24 hours of this treatment?

By signing below, I understand that topical creams, medical conditions, and certain medications can affect the results of waxing. I understand that I cannot be waxed if I have certain contraindications and I hereby release Lash and Blade harmless from and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses, and compensation for damages or loss to myself and/or property that may be caused by any act, or misinformation both intentional or accidentally on this form as well as failure to follow post-care instructions after my service.

SIGNATURE

DATE