Waxpro Waxbar Consent to WAX/SUGAR

Today's Date*

Waxing/Sugaring

Please answer the following questions, ALL information given today is fully confidential and is ONLY used so that your WAXPRO can provide the safest and most comfortable treatment possible.

Name*

First NameLast Name

Birthdate

MonthDayYear

Phone Number*

This Phone Number Is My:

Which Cellphone Carrier/Provider do you use?

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

Best way to remind you of your appt?

How did you hear about us?

Have you ever been waxed/sugared before?

What body part are we waxing/sugaring?

We want our clients to feel at ease. Lets jam to your favorite tunes during your appointment!

What is your favorite artist/or station on Spotify?

Please check any that apply to you:

Do you have any tendencies towards:

Are you currently using or taking?

Medical Data

Herpes VirusStaph/MRSAAllergiesOther

Please read carefully

Waxing/Sugaring may cause: bruising, scabs, scarring, redness, hyperpigmentation, pimples, or a flare up of any of the above mentioned conditions/responses. Waxing of soft tissue may cause the skin to tear resulting in the need for stitches. (most common occurrence is in Brazilian/Bikini waxes, male or female.)

Client Agreement:

I understand that if I have Herpes or Staph/MRSA, I may experience an outbreak after the waxing services. The professional has explained the best way to minimize or prevent an outbreak when waxing regularly.

I understand I may carry Herpes and/or Staph/MRSA without any physical symptoms or a medical diagnosis. I also understand that the waxing service does not allow the opportunity to contract these conditions from my technician.

I understand all of the above mentioned reactions. I also understand if I change my skin care routine or medications I must inform the professional PRIOR to any service in the future.

I understand that I must be showered and prepared for my service.

I understand that if I cancel my appointment within the 24-hr cancellation policy I will be charged $25.00 or HALF of the service fee. No shows will be charged 100% of the scheduled appointment!

For the purpose of documentation, I also consent to the taking of “before” and “after” photographs for facial waxing(s) only.

I have given an accurate account of the questions asked above, including all known allergies or prescription drugs or products I am currently ingesting or using topically.

I understand my WAXPRO 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 WAXPRO 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 my treatment or suggested home product/post-treatment care, I will contact my WAXPRO immediately.

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 Waxpro. I give permission to my Waxpro to perform the waxing/sugaring procedure we have discussed and waive all liabilities toward WAXPRO WAXBAR and staff from any injury or damages that may result from this treatment. I agree that this constitutes full disclosure, 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 Waxpro, whose signature appears below, 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.

By my electronic signature below, I agree to the Waxpro Waxbar client agreement above.

Today's Date*

Client Signature*

Today's Date

Waxpro Signature