Waxing Consent Form 

Today's Date *
Today's Date
Name *
Name
Phone *
Phone
Address *
Address
Birthday
Birthday
Have you ever had a professional waxing? *
Have you had any adverse reaction to waxing? *
Have you been tanning in the past 48 hours? *
Are you currently affected by any of the following conditions? *
Do you have any medical conditions, health problems, or other physical conditions that might affect your waxing service today? *
Are you currently taking any medication(s)? *
If yes, please check all that apply.
Have you recently taken any blood thinners? *
I.E. Aspirin, Alcohol, Tylenol, etc.
important note
It is my choice to recieve this waxing service. I understand that the information given above is strictly confidential and will be used for no other purpose than to assist the service provider in customizing my waxing experience. I also understand that failure on my part to disclose vital information could result in injury and/or illness and i hereby release Pop lash + Beauty bar from any claims resulting from such. Any information provided to me by the service provider is for general education purposes only and is not intended for any medical or therapeutic purposes. It is my responsibility to update the service provider if any of the above information has changed.
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