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WAX CONSENT FORM

Birthday
Month
Day
Year
Have you shaved in the last 2 weeks?
Yes
No
Have you been using Retinol?
Yes
No
Have you been exposed to high volumes of sun light or been sun burned in the last 24 hours?
Yes
No
Are there any skin conditions your provider needs to be aware of prior to your procedure? (Ex: Eczema, Psoriasis, etc.)
Yes
No
Are there any allergies your provider needs to know about for wax purposes? If so, PLEASE request "Hypo-Wax".
Yes
No
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Want to schedule another appointment? Go ahead, we'd love to have you back :)
Month
Day
Year
Time
HoursMinutes
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