Waxing Consent Form

Customer Name

First NameLast Name

Customer Email*

example@example.com

Customer Phone Number*

Please enter a valid phone number.

Customer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age*

Gender*

Please answer the health and skin checker for the safety of the procedure:*

	Yes	No	Remarks
Have you done any waxing before?
Are you currently taking any medications?
Have you had any skin thinning treatments before?
Are you Pregnant? (Female)
Do you have sensitive skin?
Do you have skin allergies?
Do you bruise easily?
Are you prone to scarring and hyperpigmentation?
Do you use a tanning bed?
Are you a diabetic?

Are you currently using any cosmetic products that may contain the following substance?*

Are you currently using any other skin thinning products and/or drugs? Kindly check if yes and if no, leave it blank.*

YesNo

Are you exposed to the sun on a daily basis or are you considering spending more time in the sun soon?*

YesNo

Are you currently taking any medications? If so, please list all (including over-the-counter drugs/herbal supplements):*

What skin products do you regularly use on your skin?*

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

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

FEMALE CLIENTS: When is your next menstrual cycle due to begin? (Always allow (5) days for menstrual cycle. Because of water retention and for your own personal comfort, you should avoid hair removal (2)days BEFORE your cycle is due and (2)days AFTER it is completed.)*

I am providing my consent to complete the procedure I am requesting for I am duly aware of the side effects of waxing to my skin during or after the procedure such as:
skin redness, swelling, skin irritation, bruises, or bumps.

I have 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 and/or skin care professional 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 and/or skin care professional 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 and/or skin care professional, 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.

I hereby affirm that I have read and fully understand the above, am over 18 years of age and am legally liable for my own decisions/actions.

By signing below, it means that I agreed to the terms indicated in this document.

ADDITIONAL TERMS

Underage Clients – Parental/Guardian Consent: If a client is under the legal age of 18, parental or guardian consent is MANDATORY for any treatment to be provided. This consent must be given in the form of a signed agreement by the parent or legal guardian, which acknowledges understanding and acceptance of the procedures and terms of service.
Verification of Consent: We reserve the right to request proof of age and verify the consent for any client who appears to be underage. This is to ensure compliance with our policies and legal obligations.
Responsibility of the Parent or Guardian: The parent or guardian who provides consent is also responsible for ensuring the underage client understands the nature of the services to be provided and agrees to the treatment.
Non-compliance with Age Requirement: In the event that a client has misrepresented their age or fails to provide the required parental or guardian consent if underage, we reserve the right to refuse service. Any deposits or payments made in such cases may be subject to forfeiture in accordance with our cancellation policy.

APPOINTMENTS

Retainer Payment: A 50% non-refundable retainer payment is required to secure all service appointments. This amount is credited towards your service on the day of your appointment.

Please remove all makeup PRIOR to your appointment, if applicable.

Please arrive 10-15 minutes PRIOR to the start of your appointment to complete all consent forms. These forms are also available online and may be completed PRIOR to your appointment. (Please note that in the event your consent forms ARE NOT completed PRIOR to the start of your appointment, this may result in a shortened appointment time.

RESCHEDULING & APPOINTMENT CANCELLATIONS

Rescheduling: If you reschedule your appointment with less than 24 hours' notice, a new retainer will be required to secure the new appointment time. To cancel or reschedule, please contact us directly by email at info@blushartistrytx.com or by phone at (832)850-6138.

Cancellation Timeframe: If you need to reschedule or cancel your appointment, please do so at least 24 hours in advance of your appointment start time.

Late Cancellations: Cancellations made less than 24 hours from the scheduled appointment start time will result in the forfeiture of the 50% retainer payment. (This policy is in place because short-notice cancellations provide insufficient time to fill the vacated slot, thereby impacting our staff and other clients.)

LATE ARRIVAL

Notification of Late Arrival: If you anticipate being late, we kindly ask that you inform us as soon as possible. This allows us to adjust our schedule and advise you on the best course of action.

Grace Period: We understand that minor and unexpected delays can happen. A grace period of 15 minutes is allowed for all appointments. During this time, we will hold your appointment slot open for you, however, please note that the original appointment time may be shortened.

Arrival Beyond 15 Minutes: If you arrive more than 15 minutes after your scheduled appointment start time, your appointment will be considered canceled. In such cases, the following terms apply:
a. Forfeiture of Retainer: Your initial 50% retainer payment will be forfeited as it compensates our staff for their reserved time and the lost opportunity to serve other clients.
b. Rescheduling Your Appointment: To reschedule your missed appointment, a new 50% retainer payment will be required. This ensures the commitment to your new appointment time and availability of our services.
c. Appointment Shortening: Depending on our booking schedule, we may offer to shorten your service instead of canceling it if you arrive within the grace period. However, this is subject to availability and cannot be guaranteed.

NO SHOWS

No-Shows: Clients who fail to show up for their scheduled appointment without any prior notification will also forfeit the retainer payment. Repeated no-shows may result in refusal of future service.

Communication: To cancel or reschedule, please contact us directly by email at info@blushartistrytx.com or by phone at (832)850-6138.

Customer Signature

Date Signed

Date

Waxing Consent Form

NOTICE:

Waiver Consent

POLICIES