Welcome.

Waxing Consent Form

Name

First Name

Last Name

Date Of Birth

Phone

(###)

###

####

Would you like to learn more about skincare and lash/brow products?

Sure!

No, thank you.

Are you currently taking any medications, including topical creams?

Do you have any allergies (e.g., to products, fragrances, latex)?

Have you used any exfoliants or chemical peels (such as Retin-A, glycolic acid) in the last 48 hours?

Do you have a history of skin conditions (e.g., eczema, psoriasis, acne)?

Are you currently pregnant or breastfeeding?

Do you have any medical conditions that may affect your waxing service (e.g., diabetes, circulatory issues)?

Have you experienced adverse reactions to waxing in the past?

Sign and Read Consent:

Please read and initial by checking each statement:

I understand that waxing may cause temporary redness, swelling, and irritation.

I acknowledge that certain medications and skincare products may increase the risk of skin sensitivity or reaction.

I agree to inform the esthetician of any discomfort during the procedure.

I understand that it is important to follow the post-care instructions provided by the esthetician to minimize the risk of complications.

I acknowledge that waxing services are not recommended for individuals with certain skin conditions or sensitivities.

Sign and Read Consent:

I, the undersigned, consent to receive the waxing service(s) indicated above. I have provided accurate and complete information and have been informed about the procedure, risks, and post-care instructions. I release the esthetician and the spa/salon from any liability resulting from this procedure.

320 Kokanee Loop
Cle Elum, WA 98922

Welcome.

Waxing Consent Form

Follow forSpeical Offers!

Follow for
Speical Offers!