Waxing Waiver Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState

Zip Code

Age?

Have you used any Alpha Hydroxy Acids (AHA) or glycolic products in the past 48-72 hours?

Have you used Retin-A, Renova, Accutane or within the past year?

How recently?

Date

Do you use any of these skincare products?

Are you using any other skin thinning products (ie. Tretinoin) and/or drugs that thin the blood?

Do you use tanning beds and/or are exposed to the sun on a regular basis?

Are you currently taking any medications? If so, please list.

Have you been treated for cancer? If yes, when and what types of therapies were used?

Please list any illness/conditions which ou are currently being treated for by a medical professional.

Do you have any open skin lesions?

Do you have any allergies?

Please list your allergies.

Do you have Herpes Simplex Virus (HSV)? (Note: Waxing can cause flare up.)

Please note that waxing can have certain side effects such as skin removal, redness, swelling, tenderness, etc.

I have read the above information and have given an accurate account of the questions and if I have any concerns, I will address these with my esthetician. I give permission to my esthetician to perform the waxing procedure we have discussed and will hold them harmless from any liability that may result from this treatment. I agree to adhere to all safety post care including: no peels, tanning, or wet room services; no swimming/spas/hot tubs for 72 hours after waxing; and all home skin care protocols as recommended by my service provider. I understand that my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

If you are unable to make your existing scheduled appointment, we kindly ask that you give us a 48 hour notice, otherwise you will be considered a "NO SHOW" and charged the full amount of the missed treatment. The best way to cancel is online through the link you are provided upon booking.

We understand delays can happen, however, we must do what we can to maintain our committed appointment times for the sake of all clients and schedules. If a client arrives more than five (5) minuets past their scheduled appointment time, it does not allow us enough time to provide the treatment. Thus the client will be considered a "no show" and charged the full amount of the missed treatment as well as a notice in the clients profile. If a client has three (3) no shows on their record we will no longer be able to book that client. Thank you for your understanding and respecting my time and business.

We would like your permission to use your photo for advertising and or social media. Your consent is necessary to do so. I herby give my permission A: to use, re-use, publish any photographic portraits or pictures of me. B: I relinquish any right that I may have to examine or approve the completed product or products advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied. C: I hereby affirm that I am over the age of 18 and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to this execution; I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns.

Date of Waiver

Date

Client Signature or Parent/Guardian Signature if client is a minor

Waxing Waiver Form

No Show/Cancelation Policy

Photo Release Agreement