Gemini waxing co consent

Gemini waxing co. Client consent form

Name

First NameLast Name

Pronouns

Address

City

State

Zip

Are you ok with before and after photos being used for Gemini Wax co social media pages? (All intimate parts will be covered and no revealing personal aspects will be shown)

NoYes

Have you been waxed before? If yes, what have you had waxed? And when was your last service?

How did you hear about Gemini?

Do you have ANY allergies? Please list any you have, if no, type N/A

Are you taking and acne medications and/or topical serums or washes contains AHA, BHA, or any other acids?

NoYes

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

NoYes

Are you diabetic?

NoYes

Are you on any skin thinning medications?

NoYes

Are you exposed to the sun/ tanning bed daily or are consider doing so?

NoYes

Are you currently taking medications? If so, please list all (Please list antibiotics as well, you can not get waxed if you are on them or have been within the last week. You may simplify your answer I.e. BC, mental health meds, etc)

What skin products do you regularly use on your skin?

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

Please list any other illness/condition you are currently being treated for by a medical professional

Unrelated to waxing- do you have any pets? If yes, plz be prepared to tell me all about them during your service (:

By signing below I consent to Gemini Waxing Co. Cancellation and no show policy. This goes as follows:

-you have 24 hours before your booked appointment to cancel for any reason. If you cancel with less than 24 hours notice, you will be charged 50% of your service price

-If you no show your appointment you will be charged 100% the service price

-if you late show your appointment, your service will be charged as a late cancellation charge of 50%

if issues arise, please do not hesitate to reach out to Gemini. We strive to be flexible and fair. A text message or phone call MAY help avoid these fees under certain circumstances!

Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc.

I have read the above information and if I have any concerns, | will address these with my skin therapist. 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. Ihave given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. I have read and understand the post-treatment home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult the esthetician immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

Client Name (signature)

Date

Gemini Waxing Co