• MEDICAL HISTORY & CONSENT/LIABILITY FORM

    The 425 Waxing Studio LLC
  • Format: (000) 000-0000.
  • Please take a moment to answer the following questions
  • Are you currently taking any medications?*
  • Please check if you are affected by or have any of the following*
  • What skin care products do you currently use?*
  • Rows
  • Do you see a dermatologist?*
  • Have you received botox or filler within the last two weeks*
  • Are you wanting The 425 Waxing Studio to customize an aftercare plan designed to achieve your goals?
  • Do you prefer a silent appointment?*
  • Are you okay with photos/videos being posted of your service?*

  • Terms & Conditions Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc.

    I have read the above information, and if I have any concerns, I will address these with my waxer. I permit my therapist to perform the waxing procedure we have discussed and will hold her harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. I have read and understand the post-treatment home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding my treatment or suggested home product / post-treatment care, I will consult the esthetician immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the esthetician responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

  • Policies (PLEASE READ)

    By agreeing to our policies, you understand that this appointment at The 425 Waxing Studio is reserved exclusively for you and requires 24-hour notice for cancellation or rescheduling. Canceled appointments within 24 hours will incur a 25% cancellation fee, and No-shows will be charged 30% of the service price unless spoken to in advance to arrange. No children under 12 in the studio unless arrangements have been made with Waxer, 620-418-2802.

  • By submitting this form, you acknowledge and agree that this document serves as proof of your consent and participation. Any attempt to dispute the transaction will be met with this evidence, confirming that you have willingly filled out and agreed to the terms stated.

  • Date*
     - -
  • Should be Empty: