Waxing Informed Consent

I have not used a scrub, Retin-A, retinols OTC, take home microdermabrasion, glycolic peels, other peels, exfoliated or tanned in the last 72 hrs. 

I have been off of Accutane for at least 12 months. 

I do not have any open skin lesions or active herpes outbreak (cold sore or genital). 

Some possible side effects include, but are not limited to, redness, swelling and pimples l, but these are temporary and generally fade within 72hrs. 

I understand that with waxing treatments certain risks are involved and that any complications or side effects from known or unknown causes could occurs. I freely assume these risks. 

I agreee to adhere to all safety post-care instructions including: no peels, tanning or wet room services; no swimming/spas/saunas/hot tubs for 72hrs after waxing; and all home skincare protocols as recommended by my service provider.

I am over 18 years of age or I have a parental co-signed giving their informed consent below. 

I will call to inform my service provider at (719) 377-3155, if I have any complications or concerns as soon as they occur. 

My signature acknowledges that I have read and agree to receive waxing treatments or a series of waxing treatments that are listed above and that I will adhere to all of the aforementioned statements that I have initialed.