Waxing Consent Form

Contra-Indications to Waxing
 

If you are taking anti-biotics or acne medication.
Use of skin peeling, skin thinning preparations.
Varicose Veins.
Underarms: Mastitis.
Skin disorders or diseases, such as bruising or recent haemorrhage, Scar tissue (especially recent).
Warts, Moles and skin tabs (area can be avoided).
Fractures or Sprains.
Bruising.
Diabetes - some people with diabetes have skin that is very slow to heal. The skin will be watched closely to make sure it does not over react to treatments.
Sensitivity test may be conducted.
Sunburn.
Use of sunbeds 24 hours prior to waxing.
If you are receiving cancer therapy (chemotherapy or radiation).

Other Considerations
 

Menstruation does not prevent you from waxing, however, your skin may be more sensitive. 
If you are pregnant, using oral contraceptives or hormone replacement your skin may be more sensitive to waxing, so it's best to have a patch test (like a small area on your arm) and see how your skin reacts for 24 hours before getting an entire eyebrow or leg wax.
If you smoke or have Rosacea waxing can irritate dilated capillaries (weak or broken blood vessels) which are commonly found on people with Rosacea and smokers. If the capillaries are very red, stay away from waxing in that area.
Stimulants such as caffeine or alcohol in your system can cause skin to be extra sensitive to waxing, meaning you could get more red or inflamed than usual. Give yourself a couple hours after drinking coffee or alcohol before getting waxed.
You might be affected if you use powerful exfoliators on your skin. Salicylic acid (found in some toners or skin clarifyers), alpha-hydroxy acid, white willow bark, white willow bark extract and enzymes all strip cells from the skin. It's all too much exfoliation combined with waxing, and could make skin red, bleed or even scab over. So stop using these products in the area getting waxed for at least three days before, and three to four days after waxing. (Depending on the strength of the product and the type of skin you have the safe wax wait time may be much longer before and after. If the alpha-hydroxy is over 8% then you may have to wait months before safely getting waxed.)

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

I confirm I have read the above information and if I have any concerns, I will address these with Belleza By Stef. I give permission to my therapist to perform the waxing procedure we have discussed and will hold her 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 that Belleza By Stef will take every precaution to minimize or eliminate negative reactions as much as possible.

I understand that I should keep the treated area free of products for 24 hours post-treatment. I am willing to follow recommendations made by Belleza By Stef 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 my therapist 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 Belleza By Stef 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.