Waxing Consent Form (Bikini & Brazilian) printable pdf download

Waxing Consent Form (Bikini & Brazilian)

Name: ________________________________________________ Date: ___________________

Address: _____________________________________________________________

City: ___________________

State: _________

Zip Code: _____________

Phone Number: _______________________________

Email Address: ____________________________________

Referred By: ________________________________

I, _________________________________ give consent to Trends Salon & Spa to perform the

following wax services:____________________________________

• I have not used a scrub, Retin-A, Retinol OTC, take home micro-dermabrasion, glycolic peels, other

peels,exfoliated or tanned in the last 72 hours. ________ (Initial)

• I have been off Accutane for at least 12 months. ________ (Initial)

• Some possible side effects include redness, swelling, and pimples, but are temporary and generally

fade within 72 hours. ________(Initial)

• (For Brazilian waxing only) I am not in my menstrual cycle. ________ (Initial)

• I do not have any open skin lesions, active herpes outbreak (cold or genital). ________ (Initial)

• I understand that with treatment certain risks are involved and that any complications or side effects

from known or un-known causes could occur. I freely assume these risks. ________ (Initial)

• I agree to adhere to all safety post care including: no peels, tanning, or wet room services for

72 hours to one week and all home skin care protocols as recommended by Trends Salon & Spa.

________ (Initial)

• I am over 18 years of age or I have a parental consent co-signed below. ________ (Initial)

• I will call to inform Trends Salon & Spa of any complications or concerns I may have as soon as they

occur. ________ (Initial)

*My signature acknowledges that I have read and agree to receive the following treatments or series

of treatments listed above and that I adhere to all the above statements I have initialed.*

Client Signature: _________________________________________Date: _________________

Witness or Parent Signature: _______________________________Date: _________________

We have the right to refuse services for all waxing if proper hygiene has not been followed.

Please cleanse before Brazilian and Bikini waxes. Thank you.

Waxing Consent Form (Bikini & Brazilian)