The V-Spot Lounge Waxing Intake & Consent Form

  • The V-Spot Lounge

    Waxing Intake & Consent Form
  • How did you hear about us?*

  • Have you had wax treatment before?*
  • If so, did you suffer any adverse reactions?*
  • Have you used any Alpha Hydroxy Acid (AHA) or glycolic products in the past 48-72 hours?*
  • Are you using Retin-a, Renova or Accutane (an oral form of Retin-a)?*
  • Are you using any other skin thinning products and/or drugs?*
  • Are you exposed to the sun on a daily basis or are you considering spending more time in the sun soon?*
  • Do you use a tanning bed?*
  • Are you diabetic?*

  • Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc.

    I confirm I have read the above information and if I have any concerns, I will address these with The V-Spot Lounge. I give permission to The V-Spot Lounge (Angilina Sexton) to perform the waxing procedure we have discussed and will hold The V-Spot Lounge (Angilina Sexton) 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 products I am currently using topically. I understand that The V-Spot Lounge will take every precaution to minimize or eliminate negative reactions as much as possible.

    I understand that I should keep the treated area free of products for 24 hours post-treatment. I am willing to follow recommendations made by The V-Spot Lounge 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 The V-Spot Lounge (Angilina Sexton) 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 V-Spot Lounge (Angilina Sexton) 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.

  • Do you agree to The V-Spot Lounge taking and posting your photograph's for advertising purposes?*

  • By signing below you are consenting to The V-Spot Lounge to take photo's of you and post them for advetising purposes.

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