Wax Consent Form🌷🍯
Be sure this form is completed before arriving to your appointment.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date - Please use appointment date.
-
Month
-
Day
Year
Date
Do any of these skin conditions apply to you?
Sensitive Skin
Eczema
Psoriasis
Rosacea
None
Are you currently using or have you used any of these products within the last 7 days
Retin-A / Retinol Products
Accutane (current or within the last 12 months)
Antibiotics
Chemical Exfoliants
Blood Thinners
None
Please list any allergies.
Do you consent to photography/videography for educational, marketing, social media, or website purposes?
YES, I give permission for photos/videos to be taken.
YES, BUT ANONYMOUSLY. I give permission for photos/videos to be taken, only if my face and identifying features are not shown.
NO, I do not give permission for any photos/videos to be taken.
Signature
Submit
Submit
Should be Empty: