Waxing Consultation Form

Waxing Pre-treatment Consultation

Please take the time to carefully fill out the following details ahead of your appointment
This information is strictly confidential and will be stored securely in your client records for future visits.

To ensure safe and effective treatments, please inform of any medical or skincare changes at future appointments.

This consultation form is valid for 12 months. I agree to inform the therapist of any changes to my health, medication, skin condition, or contraindications before each appointment

Please note: This form must be completed by all new clients and re-completed if any changes occur.
Full Name*

First NameLast Name
Email Address*
example@example.com
Mobile Number*
Format: (+44) (00000 000000).
Date of Birth *

DayMonthYear
Address*

Street Address

Street Address Line 2
CityCountyPost Code
Please indicate whether any of the following apply to you:
Have you waxed before?*

YesNo
What methods of hair removal have you used?

WaxingShavingDepilatory creamsLaser hair removalSugaringElectrolysisThreadingOther
When did you last use this method of hair removal?
Example: I last shaved 3 weeks ago
If you have had any negative reactions to hair removal, please specify:
Use of Roaccutane/strong acne products in the last 6 months*

YesNo
Current use of AHA or BHA products (Glycolic/Salicylic acid etc) - Please ensure to not use these products on the area of treatment 3-5 days prior to your appointment*

YesNo
Please list ALL medications and topical products you are using if applicable (including retinol, acne meds, steroid creams, blood thinners, AHA/BHA products): - Ensure to not use these products on the area of treatment 3-5 days prior to your appointment
Have you had any Botox or Fillers in the last 2 weeks? (This applies to getting waxed in that same area)*

YesNo
Use of any steroids/skin thinning products and/or drugs that thin the blood in the last 6 months?*

YesNo
Do you regularly use tanning beds/exposed to the sun? - Stop this 48 hours prior to your appointment*

YesNo
Do you have any recent scar tissue/cuts/bruises/abrasions to the area being waxed?*

YesNo
Do you have hypersensitive skin?*

YesNo
Are you pregnant?*

YesNo
Are you taking any medications?*

YesNo
If yes, please specify:
Do you have any of the following? (select all that apply)*

NOAllergies/IntolerancesBoilsDiabetesGenital Warts/Herpes/Cold SoreSkin infections/disorders (Eczema, Psoriasis, Ringworm, Impetigo)ShinglesHeart ConditionsHaemophiliaHigh/Low Blood PressureEpilepsy/Fits/Fainting AttacksRecent Surgery (past 3 months)Nerve DamagePrevious Reactions to WaxingCancer (please state when, and any treatments you have undergone)Other
If selected other, please specify:
Please provide additional information (if applicable) that I may need to be aware of
Do you consent to optional photos/videos that may be used for social media or marketing content? Your identity will remain fully anonymous and unrecognisable, and you can change your mind at any time.

Yes, I’m happy!No thank you!
I consent to receive waxing services and acknowledge that I’ve been informed of the potential risks and necessary aftercare, including avoiding sun exposure, tanning, swimming, and exercise for 24–48 hours after my treatment.

I confirm that the information I have provided is honest and accurate to the best of my knowledge. I understand that this form helps ensure my safety and protects the therapist from liability.

I trust that the service will be carried out professionally with care, and with my well-being as a priority.

Please sign below to acknowledge and confirm the above:
Signature*
Should be Empty:

Waxing Pre-treatment Consultation