Waxing Consent Form

Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Date of Birth

Date

Address

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contact Name & Phone Number

How did you hear about wAxxd studio & aesthetics?

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?

Are you using any 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.

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

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

I have reviewed and answered this form to the best of my knowledge. If I have any concerns, I will address these with my esthetician at WAxxd studio and aesthetics before the service. I give permission to my esthetician to perform the waxing procedure we have discussed and will not hold my esthetician accountable for any liability that may result from this treatment. I understand that my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

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 esthetician.

Signature

Everyone's time is valuable; Therefore, I have the following policies in place:

CANCELLATION POLICY:
Cancellations made within the 24-hour window will incur a 50% charge of the service fee to the client's card on file.

NO SHOW POLICY:
This is a zero-tolerance policy! No-show appointments will incur a 100% charge of the service fee to the client's card on file.

LATE POLICY:
I allot 10 minutes past the scheduled appointment time for clients that may be running behind. This helps to ensure I stay on time for all the appointments to follow. If it has reached 10 minutes after the scheduled appointment time, I will need to reschedule the appointment and you will be charged 40% of the service.

RESCHEDULING POLICY:
Similar to cancelling the appointment; The client will be charged a fee to reschedule if it is within the 24-hour window. The rescheduling fee will be $30.00 and an additional $15 hold fee to go towards the rescheduled appointment. If the rescheduled appointment has to be cancelled a second time within the 24-hour window there will be a 50% charge of the service fee. If cancelled a third time client will automatically be charged the full amount of service fee and no longer be able to schedule appointments with me.

Please Note:
Shall any of the charges not be fulfilled, the client will no longer be allowed to book future appointments until payment is received.
Failure to follow my policies or multiple violations will result in restrictions to booking and possible termination of my services.

Signature

Waxing Intake Form