New Client Form | Love Thy Waxer

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WAXING CONSENT FORM

First name

Date of Birth

Last name

Do you have any allergies? If so, list below

Have you used any of the following medications or topicals in the past? * Required

Yes, Accutane prescription.

Yes, Retinol/Retin-A/Retinoids topicals.

Yes, glycolic/salicylic products.

Yes, antibiotics.

No, I have not used any of the above.

Are you currently pregnant? *

Yes

No

Have you had sun exposure in the last 24 hours? *

Yes

No

Do you have minimum 3 weeks of hair growth? *

Yes

No

Are you 18 years or older? *

Yes

No

I have read and agree to LOVE THY WAXER LLCPolicies, Terms and Conditions

Referred by:

Your Signature

Thanks for submitting!

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