Seasational Spa Waxing Consent Form

How did you hear about us?

If referred, who do we thank?

Please ensure to put first and last name.

Name

First NameLast Name

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Have you used any Alpha Hydroxy Acids (AHA) or glycolic products in the past 48-72 hours?

Have you used Retin-A, Renova, or Accutane within the past year? If so, when? If not, type ‘N/A.

Are you using any other skin thinning products and/or drugs that thin the blood?

Do you use tanning beds and/or are exposed to the sun on a regular basis?

Are you currently taking any medications? If so, please list. If not, type ‘N/A’.

Have you been treated for cancer? If yes, when and what types of therapies were used? If no, type ‘N/A’.

Please list any illness/conditions which ou are currently being treated for by a medical professional. If none, type ‘N/A’.

Do you have any open skin lesions?

Do you have any allergies? If so, please list. If none, type ‘N/A’.

Please note that waxing can have certain side effects such as skin removal, redness, swelling, tenderness, etc. I have read the above information and have given an accurate account of the questions and if I have any concerns, I will address these with my technician. I give permission to my technician to perform the waxing procedure we have discussed and will hold her harmless from any liability that may result from this treatment. I agree to adhere to all safety post care including: no peels, tanning, or wet room services; no swimming/spas/hot tubs for 72 hours after waxing; and all home skin care protocols as recommended by my service provider. I understand that my technician will take every precaution to minimize or eliminate negative reactions as much as possible.

PAYMENT:

I understand that I have already sent/paid my 50% non-refundable deposit prior to my appointment date and time. I also understand that the remaining balance is due at the end of my appointment. I understand that there is an 100% charge for no call no show as well as being banned from future booking until my unpaid balance is paid in full.

I HAVE READ, UNDERSTAND, AND ACCEPT ALL POLICIES LISTED BY SEASATIONAL SPA.

Date

Signature

Body Waxing Consent Form

Address