Client Consent Form
Clients must fill out this form before an appointment (Only Once). Please answer ALL questions truthfully. PLEASE READ ALL POLICIES ON INSTAGRAM BEFORE BOOKING. A $10 deposit is required to book.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
When is your birthday? (MM/DD/YEAR)
*
For any promos to be added for your birthday month
Have you had any recent surgeries or medical procedures? If yes, what surgery or medical procedures? (Skip if none)
*
Please check any of the following conditions you may currently have?
*
Diabetes
Cancer
Eczema
HIV/ AIDS
Skin Infection
Herpes simplex
High blood pressure
Lupus
Period
Spotting
Pregnacy
Sunburn
Dry Skin
Sensitive skin
Psoriasis
Other
Are you taking any of the following?
*
Accutane or Tetracycline
Revona
Retinoids such as retin-a
AHA / Alpha-Hyroxy Acid
BHA / Beta Hyroxy Acid
Glycolic Acid
None
Do you have any allergies? If yes, please state all below. (Latex, Beeswax, etc.)
*
I have read and understand all policies on WaxedByKi instagram page & agree to all policies listed.
*
Yes
No
I consent to "Before and After" photographs for documentation, potential advertising, and promotional purposes. (No face will be shown.)
*
Yes
No
Are you 18 years of age or older?
*
Yes
No
If your under the age of 18 please read the following.
Clients under the age of 18 are required to be accompanied by a legal guardian when receiving any intimate service at Waxed By Ki. This policy applies to strictly on all intimate waxing services. Waxed By Ki reserves the right to request proof of age for clients who appear to be under 18 years old.
(PLEASE SIGN) I understand that waxing treatments carry some risks, including the potential for allergic reactions and skin irritation. I release the wax specialist from any liability from my waxing service preformed.
*
Submit
Submit
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