AV BEAUTY - WAXING CONSENT FORM

AV BEAUTY - WAXING CONSENT FORM
Full Name
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth

MonthDayYear
Date
Emergency Contact Name Number
Medical History Please list any that apply to you:

I am currently using Accutane or have used it in the past 6 months

I use Retin-A, Retinol, or other exfoliating skin product

I am currently taking antibiotics

I am pregnant or nursing

I have diabetes or poor circulation

I have sunburn, rash, or irritation in the area to be waxed

I've had a chemical peel, microdermabrasion, or laser treatment within the past 2 weeks

I have a history of cold sores or herpes (for facial waxing)
List
Acknowledgment & Consent
Check:
Check:
Check:
Check:
Check:
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Check:
AV BEAUTY - PHOTO CONSENT FORM
Check:
Check:
Client Signature
Date

MonthDayYear
Date
Date

MonthDayYear
Date
Esthetician Signature
Should be Empty: