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Waxing Consent
APPOINTMENT DATE
MonthDayYear
Date
CLIENT NAME
CONTACT NUMBER
ADDRESS
PERFORMED TODAY?
BODY WAXING
UNDERARMSBACKFULL ARMHALF ARMFULL LEGSHALF LEGSSTOMACHNECK/NAPE
FACIAL WAXING
BROW RESHAPECHINLIPFULL FACE
EMAIL
example@example.com
INTIMATE WAXING
FULL BRAZILIAN
HOW DID YOU HEAR ABOUT US?
OTHER
-0-21
MENS WAXING
BACK
ELEMENT NINE DAY SPA
NOSE
ELEMENT NINE
CHEST
CHEST
EYEBROWEAR
@element_nine_day_spa
FULL ARM
WAXING
CONSULTATION
THE FOLLOWING MAY DETERMINE WHETHER YOU ARE AN IDEAL CANDIDATE FOR WAXING
DO YOU EXPERIENCE THE FOLLOWING? PLEASE MARK BELOW
INGROWN HAIR
SENSITIVE SKIN
SKIN DISORDER
SCAR TISSUE
HERPES
COLD SORES
HAVE YOU HAD ANY ADVERSE REACTIONS OR ALLERGIES? PLEASE ADVISE
ARE YOU CURRENTLY TAKING ANY MEDICATIONS THAT MAY BE A CONTRAINDICATION TO WAXING? PLEASE ADVISE
WAXING
CONSENT FORM
YOUR SATISFACTION AND SAFETY IS OUR NUMBER ONE PRIORITY TO ENSURE YOUR WELLBEING BEFORE. DURING AND AFTER YOUR WAXING TREATMENT
I HERBY GRANT PERMISSION TO ELEMENT NINE TO USE ANY PHOTOS AND/OR VIDEOS TAKEN OF ME ON SOCIAL MEDIA, PUBLICATIONS. ONLINE AND ANY OTHER COMMUNICATTONS RELATED TO ELEMENT NINE. YESNO
NO
IHAVE CITED ALL CONDITIONS AND CIRCUMSTANCES REGARDING MY HEALTH HISTORY,
Including any past reactions to products or medications that could prohibit or compromise this treatment
I UNDERSTAND THAT ADDITIONAL CONDITIONS COULD OCCUR WHICH COULD AFFECT MY ABILITY TO TOLERATE THIS WAXING TREATMENT
I further understand there are risks associated I acknowledge that my skin may experience temporary irritation and certain side effects such as skin removal. bumps. itching. redness. soreness. swelling. and/or tenderness depending on skin sensitivity
WILL NOT HOLD MY TECHNICIAN OR BUSINESS PERFORMING THIS SERVICEON ME RESPONSIBLE IN ANY WAY FOR ANY ISSUES THAT MAY ARISE AS A RESULT OFHAVING THIS WAXING TREATMENT PERFORMED
I understand that even though Element Nine uses the proper technique with utmost attention to safety and proper procedure protocols. the instruments and wax used may cause irritation. itching or discomfort and may require a medical professional's follow-
I UNDERSTAND THAT AFTERCARE NEEDS TO BE FOLLOWED TO MAINTAIN THE HEALTH OF MY SKIN
As part of my aftercare, I should minimize prolonged sun exposure. use sun protection and avoid aggressive exfoliation/beauty treatments on the area for at least 48 hours
I CONSENT TO THE BEST OF MY KNOWLEDGE THAT THE ANSWERS - HAVE GIVEN ARE CORRECT AND THAT I HAVE NOT WITHHELD ANY INFORMATION THAT MAY BE RELEVANT TO MY TREATMENT
I release Element Nine any liability associated with any injuries and/or current and future conditions resulting from this waxing treatment
You hereby acknowledge and confirm thet you ore or have ceco fully informed to the nature of the service you nove requested and ore aware with all risks essociated. Yau infermed your of dey are existing conditions. allergies or sensitivities that way impact on treatment. We are not liable for any discomfort d'amage. 1811 of injury you may incor arising directly or sul of dry services previded or any svoduct Complimentory services or are enly effeced 00 the repress understording ther the service offered is net and may not be deemed as en of liobility or fault and are allo subject to the conditions of this agreement.
CLIENT | NFORMATIO N
FOR PROFESSTONAL USE
CLIENT NAME
TREATMENT DATE
MonthDayYear
Date
MEDICAL HISTORY
SKIN TREATMENT HISTORY
WAXING TREATMENT INFORMATION
AREA/S WAXED
CLIENT S K I N CONDITION BEFORE
CLIENT SKIN CONDITION AFTER
NOTES
AFTERCARE RECOMMENDATION
Should be Empty:

Waxing Consent

PERFORMED TODAY?

ELEMENT NINE DAY SPA

NOSE

WAXING

CONSULTATION

WAXING

CONSENT FORM

I UNDERSTAND THAT ADDITIONAL CONDITIONS COULD OCCUR WHICH COULD AFFECT MY ABILITY TO TOLERATE THIS WAXING TREATMENT

WILL NOT HOLD MY TECHNICIAN OR BUSINESS PERFORMING THIS SERVICEON ME RESPONSIBLE IN ANY WAY FOR ANY ISSUES THAT MAY ARISE AS A RESULT OFHAVING THIS WAXING TREATMENT PERFORMED

I UNDERSTAND THAT AFTERCARE NEEDS TO BE FOLLOWED TO MAINTAIN THE HEALTH OF MY SKIN

CLIENT | NFORMATIO N

FOR PROFESSTONAL USE

WAXING TREATMENT INFORMATION