Waxing Intake Form

Please read the following waiver carefully before participating. By signing this waiver, you agree to the terms and conditions outlined below.

Participant Name:

First Name

Middle Name

Last Name

Participant Phone Number:

Date

Date of Birth

Participant Address:

Participant Email:

Do you have any of the following skin conditions?

Eczema

Psoriasis

Hyperpigmentation

Dry Skin

Text above short answer field...

I give permission to the technician below to perform the Waxing service.

I understand that after the waxing procedure, temporary side effects such as redness, irritation or discomfort may occur.

I agree to follow the aftercare instructions provided by the esthetician to minimize the risk of complications and ensure optimal results

I understand the results of waxing are temporary and may vary depending on factors such as hair growth cycles, skin type and maintenance habits.

Client Signature:

Date Selector

Technician Signature:

Date Selector