Facial Waxing Release form

To better accommodate our clients during the pandemic we’re going digital. Sign your facial waxing release form below and you won’t have to do it when you come in for your appointment.

Waxing for hair removal, particularly on the face carries risks. These risks may include redness, bruising and lifting of the skin. These conditions may be exacerbated using certain pharmaceuticals and cosmetics, particularly those for anti-aging and anti-acne treatments. Examples of these are retinoid, Retin-A, Renova, accutane, and alpha hydroxyl acids (AHA’s) like glycolic acid. Face waxing should be avoided when using these products.

Certain prescription medications may aggravate the skin when waxed, particularly those causing photo-sensitivity (sensitive to sunlight). Examples of these are many antibiotics, such as tetracycline, and blood thinners such as Warfarin, which may cause an individual to bruise easily.

Clients who are receiving aesthetic and dermatological peeling treatments may also experience redness and skin lifting from waxing and therefore should avoid waxing while undergoing such treatments. The use of tanning booths can also contraindicate waxing. Waxing should not be done 24 hours before or after tanning. It should also not be done on an area that still shows an erythema (redness) from tanning. Because the fields of pharmacology and dermatology are continually changing and expanding, there may be products and drugs that cause negative reactions to waxing that have yet to be documented.

Client Name

First Name

Last Name

Date of Appointment

YYYY

Clients Acknowledgement

▪ I have read the information on this form and fully understand the information presented to me. ▪ I use none of the products known to cause a negative reaction with waxing. ▪ I am receiving no skin treatments known to cause a negative reaction to waxing. ▪ I understand that waxing may involve certain minor risks (e.g. redness, sensitive reaction, bruising and lifting of the skin), and I fully accept all responsibility associated with these risks.

By checking this box and typing my name below, I am electronically signing my application

Digital Signature

(Parent/Guardian if under 18 years of age) I have agreed to submit this form by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

First Name

Last Name