Waxing Waiver Form

Waxing Waiver Form

Provided by Eyedentity Studio | 3242 NE 45th St, Seattle, WA 98105 | 206.567.7705
3242 NE 45th St Seattle, WA 98105 206.567.7705
First & Last Name
Phone number
Email
example@example.com
Any known allergies?

YesNo
If yes, what are they?
Are you currently using tanning beds?

YesNo
Are you currently using tanning beds? Y / N Do you have or have you had any of the following medications or medical conditions that could compromise your skin and/or services being offered: (Circle any that apply)
Do you have or have you had any of the following medications or medical conditions that could compromise your skin and/or services being offered?:

AccutaneAdapleneIsotretinoinRetin-aRenovaAlustraAvitaTazaroteneTretinoinAvageDifferinPregnancyAntibiotics
Were there any issues last time you got waxed?

YesNo
If yes, what were they?
Client Agreement

I understand that if I begin use, or are currently using, any of the products listed in the above warning and do not inform the esthetician prior to current or future treatment, I accept full responsibility for any adverse reactions. I understand that waxing may cause some redness, bumps, soreness, and/or itching. I UNDERSTAND THAT 50% REFUND OF COST OF SERVICE WILL BE GIVEN FOR ANY ALLERGIC REACTION.
CLIENT CONSENT (OVER 18 YRS OF AGE):
By typing my name in the box below, I agree to the terms of receiving waxing services from Eyedentity Studio.
Date

MonthDayYear
Date
PARENT/GUARDIAN CONSENT (UNDER 18 YRS OF AGE):
By typing my name in the box below, I agree to the terms of my child receiving waxing services from Eyedentity Studio.
Date

MonthDayYear
Date
Should be Empty:

Waxing Waiver Form

Client Agreement

CLIENT CONSENT (OVER 18 YRS OF AGE):

PARENT/GUARDIAN CONSENT (UNDER 18 YRS OF AGE):