Waxing Consent Form

Waxing Consent Form
Client

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
By checking the following boxes, confirm that you willingly consent to the following terms and conditions:

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

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Date
Client Signature

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