Brow Lamination Consent Form

BROW LAMINATION, WAXING & TINTING CONSENT + CLIENT INTAKE FORM

Welcome love! Please complete this form thoroughly to ensure a safe and comfortable experience. ♡
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Email
example@example.com
Emergency Contact & Phone Number*
How did you hear of LasshedbyLucy? Were you referred ?
MEDICAL HISTORY & SKIN CONDITIONS

Please check any that apply.
General Health*

Pregnant or breastfeedingDiabetesThyroid disordersEpilepsy or seizuresAutoimmune disorderHormonal imbalancesNone of the above
Skin Conditions or Reactions*

Eczema / Psoriasis / RosaceaDermatitis or hypersensitive skinCold sores / Herpes simplex (near brow area)History of Keloid or raised scarringBroken skin, open wounds, or active acne in the brow areaPrevious allergic reactions to waxing, tint, or brow servicesEye infections (conjunctivitis/styes) or skin infectionsNone of the above
Medications & Products (important for waxing/lamination)*

Retin-A, Retinol, or topical Vitamin A (at least 3 days)Accutane (oral isotretinoin — must be off for 6+ months before waxing)Alpha Hydroxy Acids (AHA – glycolic, lactic acids)Beta Hydroxy Acids (BHA – salicylic acid)Benzoyl peroxide (acne creams)Steroid creams or topical corticosteroidsChemical exfoliants / facial peels / enzyme treatmentsBotox, fillers, microneedling, or cosmetic proceduresNone of the above
If yes, please list the products or medications and when you last used them:
WAXING CONTRAINDICATIONS & SKIN SENSITIVITY CHECK

Please answer the following:
Have you been waxed before?*

YesNo
If yes, did you experience any irritation or allergic reaction?
Have you had any chemical peels, enzyme treatments, microdermabrasion, or laser resurfacing in the last 4–6 weeks?*

YesNo
Have you been exposed to tanning beds, spray tan, or sunburn in the last 72 hours?*

YesNo
Do you currently use any skincare products containing acids, retinoids, or exfoliants?*

YesNo
Do you bruise, swell, or bleed easily from waxing or tweezing?*

YesNo
Have you had any allergic reactions to tinting, dye, peroxide, wax, or brow lamination solutions in the past?*

YesNo
If yes, did you experience any irritation or allergic reaction?
SERVICE DETAILS – INFORMED CONSENT

Please read and initial each:
Brow Lamination: A chemical treatment to straighten and set brow hairs in place for a fuller look. May involve processing creams, neutralizers, and nourishing oils.
Brow Tinting: A semi-permanent dye used to darken the brows. Typically lasts 2–3 weeks.
Brow Waxing: Removal of hair using soft or hard wax to define brow shape. Redness or skin lifting can occur, especially with sensitive skin or active ingredients.
I understand the nature of the brow lamination, tinting, and waxing services.*
Initial
I have disclosed any relevant allergies, medications, and skincare use.*
Initial
I understand that side effects such as redness, irritation, dryness, or allergic reaction are possible.*
Initial
I understand that waxing may cause sensitivity or lifting of the skin if I am using contraindicated products.*
Initial
I agree to follow all aftercare instructions provided by my technician.*
Initial
I release the technician and salon from liability should any adverse reaction occur.*
Initial
I understand that results vary and no guarantees can be made.*
Initial
I Agree to the Late Policy*
Initial
I Agree to the Deposits & Payment Policy*
Initial
I Agree to the Cancellation/No-Show Policy*
Initial
Client Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

BROW LAMINATION, WAXING & TINTING CONSENT + CLIENT INTAKE FORM

MEDICAL HISTORY & SKIN CONDITIONS

WAXING CONTRAINDICATIONS & SKIN SENSITIVITY CHECK

SERVICE DETAILS – INFORMED CONSENT