Hello ! Welcome to Brow Baddie Lyd
This form is to ensure we have full consent !
General Waxing
brows, and or body waxing !
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
I
Name
provide awareness to the following below.
I am aware that there are side effects to waxing treatments including, but are not limited to, itching, skin allergies, redening of the skin, swelling or bumps.
Please Select
yes
no
I confirm that all reactions, sensitivities, and hazards have been disclosed to me, and I have been given the opportunity to ask questions.
Please Select
yes
no
l assume full responsibility for any possible dangers, reactions, and sensitivities, and I have informed my provider of any allergies.
Please Select
yes
no
I understand and agree that I will call my provider promptly if I suffer an adverse response. I am aware that I may be required to seek medical care at my own expense.
Please Select
Yes
No
I will not hold my provider accountable for any responses, sensitivities, or injuries that may arise from this treatment.
Please Select
Yes
No
I understand that my provider has the right to refuse for all waxing treatment services as my provider sees fit. Proper hygiene must be followed and I will let my provider know if I am currently menstruating.
Please Select
Yes
No
I am over the age of 18 or I have parental consent co-signed below.
Please Select
yes
no
If you are under age requirements, you have contacted your guardian to ensure that it is appropriate and acceptable to provide treatment today or with future appointments.
Please Select
Yes
No
By signing below, I herby acknowledge that I have completely read and fully understand the above agreement.
Signature
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: