• Waxing Intake & Consent Form

  • You may experience skin sensitivity/thinning, which can result in skin lifting, from the following: 

    - Sunburned Skin    - Rentinol

    - Pregnancy           - Antibiotics 

    - Menstruation    

     - Certain Medical Conditions 

    - Other Medications Not Listed

     

  • PLEASE READ


    I UNDERSTAND THAT IF I BEGIN USE, OR ARE CURRENTLY USING, ANY OF THE PRODUCTS LISTED IN THE ABOVE WARNING AND CHOOSE NOT TO INFORM THE ESTHETICIAN PRIOR TO CURRENT OR FUTURE TREATMENTS, I ACCEPT FULL RESPONSIBILITY FOR ANY ADVERSE REACTIONS. 

    I UNDERSTAND THAT WAXING MAY CAUSE SOME TENDERNESS, SWELLING, REDNESS, BUMPS, SORENESS, AND/OR ITCHING. 

    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 Esthetician. I give permission to my Esthetician 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, no sex for 24 hours, no 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 Esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

  • Clear
  •  PARENT/GUARDIAN CONSENT ( UNDER 18 YRS OF AGE) :
     I,    , Authorize MD ESTHETICSTRY to provide waxing services (with the exclusion of Brazilian Waxing Services) on     ( a Minor). 
    NO BRAZILIAN WAXES WILL BE PROVIDED FOR MINORS.

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