Serene Skin OC WAXING Intake Form

  • Serene Skin OC Waxing Intake Form

    Please take a few moments to fill out this form. This is to ensure your understanding and safety during your service. **Please note: This form will only need to be filled out once per year. If there are any updates or changes it is your responsibility to inform me. For any questions/concerns, feel free to contact me at (714)393-5042.
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  • Date of Birth*
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  • Have you been waxed before?*
  • Do you have any allergies?*
  • Have you taken Accutane in the past 12 months?*
  • Do you use tanning beds?*
  • Do you experience any of the following?:*

  • Are you currently using any of the following medications/ ingredients?*

  • **WARNING** If you selected any of the following above, please note that you may be contraindicated to receiving a specific serive. If you are using any of the products and/or medications above, discontinue use for a MINIMUM of 7 days before service to reduce risk of negative reactions. Please contact me, Kayla, at (714)393-5042 with any concerns or to reschedule appointment.

  • Are you pregnant, lactating, or nursing?*
  • Do you consent to pictures and/or videos to be taken for progress and/or social media content?*

  • I hereby agree that I have cited all conditions and circumstances regarding my health history including medications being taken and any past reactions to products or medications that could prohibit or compromise this service. I will not hold Serene Skin OC responsible in any way for any issues that may arise as a result of having this waxing procedure. I understand that even though Serene Skin OC uses the proper technique with the utmost attention to safety and proper procedure protocols, the instruments and wax used may cause irritation, itching, or discomfort and may require a medical professionals follow up care 

  • I understand that aftercare needs to be followed. As as part of my aftercare, I should minimize prolonged sun exposure, avoid aggressive exfoliants, avoid sweating or excessive exercise, and bodies of water for 24-28hrs post appointment. For body/intimate waxing: after 72 hrs begin exfoliating area 2-3x per week and moisturize daily until next appointment

  • You hereby acknowledge and confirm that you are or have been fully informed as to the nature of the service you have requested and are aware with all the risks associated. You have informed you technician of any pre-existing conditions, allergies, or product sensitivities that may impact your treatment. We are not liable for any dissatisfaction, discomfort, damage, loss or injury you may incur arising directly or indirectly out of any services provided or any product used. Complimentary services or treatments are only offered on the express understanding that the service offered is not and may not be deemed as an admission of liability or fault and are also subjected to the conditions of this agreement

  • Date Signed
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