New Client Intake/Hair Removal Liability Form

Name*

First NameLast Name

Date*

Date

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Birthday:*

Date

Cancellation, No Show and Late Policy

I charge a 100% cancellation fee for any no shows or cancellations within 48 hours of the scheduled appointment. For late arrivals, I do have a 5 minute late policy, if you're going to be more than 5 minutes late please reach out via text or phone call, otherwise you will be marked as a no show and charged accordingly. Out of respect and consideration to myself and other clientele, please plan accordingly and be on time.

Yes

Policies and Guidelines

•Only one person, besides the service provider, is allowed in the studio at a time. The only exception to this policy is if you are under the age of 18 and a parent/guardian may be in the studio with the client.

•No children are allowed within the suite.

•There are no refunds for any services rendered.

•Any inappropriate or disrespectful comments or behavior towards staff will not be tolerated, the service will be ended, you will be asked to leave and charged for the service. You will no longer be allowed to book.

Yes

YesNo

Do you suffer from any medical problems? (e.g. diabetes, high blood pressure if so please list)

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

YesNo

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

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

YesNo

Please note that waxing and sugaring 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 aesthetician. I give permission to my aesthetician to perform the waxing or sugaring 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 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.*