Wax Consultation

Wax Consultation
Name*

First NameLast Name
Date of birth*
Gender & pronouns
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Phone Number*

Area CodePhone Number
Ethnicity
Race
Before your appointment:

Don't shave within 2 weeks

Wear loose clothing/ go commando

Exfoliate 72 - 48 hour prior

Take paracetamol 30 minutes (minimum) to 1 hour (maximum) before your appointment

If you are on your period: weara tampon or a menstrual cup
Appointment you chose
Is this your first wax?

YesNo
Are you on your period?

YesNo
Occupation:
Doctors name & address
Any known medical conditions or allergies?
Are you taking any medication
Have you got any contraindications?
Contraindications requiring medical referral?
Contraindications restricting treatment
Do you want all hair gone?

YesOnly the sidesJust leave a strip
Do you accept our terms & policies?*

Yes
Signature*

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