Waxing Consent Form

Client

First NameLast Name

Phone Number

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

Email

example@example.com

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 not used a scrub, Retin-A, Retinol OTC, take home micro-dermabrasion, glycolic peels, other peels, exfoliated or tanned in the last 72 hours.I have been off Accutane for at least twelve (12) months.I understand that some possible side effects include redness, swelling and pimples, but these are temporary and generally fade within 72 hours.For Brazilian and/or bikini waxing, I will notify my therapist if I am on my menstrual cycle.I do not have any open skin lesions or active herpes outbreak (cold sore or genital).I recognize that the results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost.I am over 18 years of age or I have parental consent co-signed below.If I have any concerns, I will address these with my therapist.I have read and understand the post-treatment home care instructions and understand how important it is to follow all instructions given to me for post-treatment care.

I verify that the information I have provided on this form is truthful and accurate. I have read, understand, and checked all the terms and conditions. I release Forevermose SkinCare & Lashes, estheticians, wax specialists, workers, and all of the parties related to the Forevermore SkinCare & Lashes from any and all of the claims and demands including damages, diseases, and or injuries.

Date

Client Signature