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  • How did you find us?

  • Is your skin?*
  • Is your skin sensitive!*
  • Acne?*
  • Discoloration in skin tone?*
  • Do you use tanning beds?
  • Have you used any Alpha Hydroxy Acid (AHA) or glycolic products in the past 48-72hrs?
  • Are you using any Retin-A, Renova, Accutane (an oral for of Retin-A)
  • 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, I will address these with my skin therapist.

    I give permission to my service provider 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.


    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 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.

     

    PRE AFTER CARE INSTRUCTIONS:
    - No Alcohol
    - Come in clean before your appointment
    - Wear LOOSE/BREATHABLE clothing
    - Bring an extra clean undergarment for after a Brazilian wax
    - No exfoliating the day of your appointment - but you can exfoliate 4 days before your appointment

    POST AFTERCARE INSTRUCTIONS:
    To Avoid Irritations & Breakouts
    - No Intimacy for 24 hours
    - No high intensity workouts for 12 hours
    - Avoid the sun/apply sunscreen
    - Hydrate with a light oil daily
    - 3 days after your wax you can start to gently exfoliate
    - Exfoliate 1-2x a week with a fragrance free sugar scrub or a clean exfoliating mitt gently

  • I grant permission for photos and/or videos taken before, during, or after my

    service to be used for:

    • Marketing and advertising

    • Social media and website content

    • Educational purposes

    No personal identifying information will be shared without my consent.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
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