Waxing Consent Form

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Age?

If under 18, parents signature is also required. They are required to be present for any services.

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

YesNo

Have you used Retin-A, Renova, or Accutane within the past year? If so, when?

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

YesNo

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

YesNo

Are you currently taking any medications? If so, please list.

Have you been treated for cancer? If yes, when and what types of therapies were used?

Please list any illness/conditions which ou are currently being treated for by a medical professional.

Do you have any open skin lesions?

YesNo

Do you have any allergies? If so, please list.

Do you consent to before and after pictures for educational purposes on social media?

YESNO

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 Esthetician. I give permission to my Esthetician to perform the waxing procedure we have discussed and will hold them 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 24 hours after waxing; and all home skin care protocols as recommended by my service provider. Regarding lash lift and tints, I agree to adhere to all safety post care including: being gentle with lashes, no rubbing; avoid wetting lashes for 24 hours; no harsh products on or around lashes/eyes; swimming/saunas/steam should be avoided for at least 24 hours; avoid waterproof mascara; refrain from receiving beauty treatments for 24 hours. I understand that my Esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

I agree to The Wax Babe's no show/cancellation policy. Reschedules/cancellations with less than 24 hours notice will be charged 50% of all scheduled services. No call/no shows will be charged 100% of all scheduled services. All no call/no shows will be required to prepay for future appointments. Myself and guests have a 10 minute grace period. Please contact me if you are going to run past this grace period so I can accommodate you. Please note in the event I'm fully booked, you will need to reschedule for a different day.

Signature

Date: