WAX HAIR REMOVAL CONSENT FORM

Date*

Date

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

I am aware that discomfort may occur during the removal of the hair. If discomfort is experienced and I cannot continue, I will notify my esthetician immediately.*

I agree to follow all post-treatment home care instructions.*

I understand that I cannot be waxed if certain contraindications such as taking topical acne drugs or if I am using Retin-A® (or other peeling agents) prescription products.*

I understand certain medications, products, and treatments used prior to the treatment can result in irritation, skin peeling, blotchiness, pigmentation and sensitivity.*

I agree to avoid the following after the waxing procedure: saunas, steam rooms, hot tubs or other heat sources; avoid application of exfoliating AHA/BHA products for 48 hours; avoid using a loofah or other abrasives on the waxed area.*

I have given an up to date and honest records of my medical history and doctor prescribed medications.*

I understand that I am accepting full responsibility for skin reactions if I do not inform my technician of contraindications prior to waxing.*

I understand the hair removal process has been explained and I have had an opportunity to ask questions and receive satisfactory answers.*

I consent to be waxed and will not hold the LUX BOY LAB responsible for any adverse reactions from treatment or products.*

SIGNATURE*

WAX HAIR REMOVAL CONSENT FORM

CLIENT MEDICAL HISTORY