EmailMe Form - WAXING CONSULTATION FORM

Name *

First Last

Email *

Contact Number *

Date of your appointment

MM / DD / YYYY

What body part are we waxing today?

When did you last shave or trim?

MM / DD / YYYY

Have you been waxed before?

Yes

No

Do you have any tendencies towards:
(check all that apply)

Are you currently using or taking:
(check all that apply)

Waxing may cause: Bruises, scabs, scarring, redness, hyper pigmentation, pimples or a flare up of any of the above mentioned Conditions/responses. Waxing of soft tissue may cause the skin to tear resulting in the need for stitches. (Most common occurrence is in Brazilian Bikini waxes, male or female.) *

I understand that if I have Herpes or Staph/MRSA, I may experience an outbreak after the waxing service. The professional explained the best way to minimize or prevent an outbreak when waxing regularly. *

I understand I may carry Herpes and/or Staph/MRSA without any physical symptoms or a medical diagnosis. I also understand that the waxing service does not allow the opportunity to contract these conditions from my technician. *

I understand all of the above mentioned reactions. I also understand if I change my skin care routine or medications I must inform the professional PRIOR to any service in the future. *

I understand that I must be showered and prepared for my service. *

I understand that if I cancel or miss my appointment within the 24 hour cancellation policy I will be charged $25.00 or HALF of the service fee, whichever is greater. *