Waxing Consent Form

Have you ever had professional waxing? *

Yes

No

Have you ever had an adverse reaction to waxing? *

Yes

No

Have you been had a peel, microdermabrasion, or tanned in the past 48 hours? *

Yes

No

Are any of these conditions present in areas to be waxed?

(Mark ALL that Apply)

Varicose Veins

Recent Surgery

Sunburn

Allergies

Rash

Scar Tissue

Herpes

Warts/HPV

Menstruation

Fungus

Infection

Ingrown Hair

Moles

Acne

Signature *

First Name

Last Name

Date *

MM

DD

YYYY