Waxing Consent Form

1. Please check any of the following that apply to you:
2. Please list all known allergies:
3. List any prescription drugs you are currently taking:
Please note that waxing has certain side effects such as skin removal, redness, swelling, tenderness, etc. If you have any concerns please address them with your specialist as soon as possible.   
I have read the above information and if I have concerns, I will address these with my Esthetician. I give permission to my Esthetician to perform the waxing procedure(s) we have discussed and I release THE SPA SOCIETY and my Esthetician of any liability that may result from this procedure(s). I have given an accurate account to the questions above including all known allergies, prescription drugs, and products I am currently ingesting or using topically. I understand my Esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.   After care instructions will be provided to me. I am willing to follow recommendations made by my specialist for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding the procedure(s) or suggested home care regime/products, I will consult my Esthetician immediately.   I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure(s) and accept the risks. I do not hold THE SPA SOCIETY or the Esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of the treatment(s), which may be affected by the procedure(s) performed today.
By signing this consent you give the Esthetician permission to perform waxing services, and fully understand all the risk associated with the service. *