Sugaring Intake Form

Sugaring Intake Form
Name
First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
DOB
MonthDayYear
Date
What drew your attention to us?
Have you been sugared before?
YesNo
Have you recently had a chemical peel, microdermabrasion, or tanned?
YesNo

Please read and double-check everything. Risks to be aware of, as well as further information.

	Check Status
I understand that any blood thinners, alpha hydroxy/glycolic acids, Retin A, or Accutane are contraindicated and may induce skin lifting. It is not advisable to have your hair removed. This should be avoided for at least two weeks before hair removal.	1
I understand that waxing/sugaring is not recommended if you have uncontrolled diabetes, open wounds, sunburn, or varicose veins. It is unable to provide service.	2
Sugaring, I understand, can cause brusing, ingrown hair, skin irritation, redness, and inflammation.	3
I understand that it is my responsibility to inform my Esthetician if I have any medical conditions now or in the future.	4
I give my Esthetician permission to undertake the sugaring/waxing hair removal we discussed, and I agree to hold harmless and nameless from any liability that may arise as a result of treatment.	5
I accept that I shall consult Esthetician if I have any issues about the treatment.	6

BIKINI AND BRAZILIANS:
Please maintain the same level of hygiene as you would for a doctor's visit. Having clean, dirt/debris-free skin and hair. Before the service, an intimate wipe will be administered. If you have menstruation, you must use a clean tampon or cup. If adequate hygiene is not followed, the esthetician has the authority to refuse service.
This service also necessitates some special stance as well as your probable participation in skin tightening. Both provide a more comfortable treatment and make hair removal easier.
LATE POLICY
If you arrive more than 10 minutes late for a service appointment, it may be cancelled (recorded as a no show) and you may be charged a fee or your appointment time may be reduced.
CANCELLATIONS
When at least 12 hours notice is given, appointments can be canceled or rescheduled without charge. There will be a charge if an appointment is canceled or rescheduled with less than 12 hours notice.
We have zero tolerance for innuendos, advancements, coercion, suggestive conduct, language, or intimidation related to sexual harassment. Any of this could lead to a police investigation.
Media Release
Please keep in mind that all films and photographs are for educational and marketing reasons only. Your identity is kept confidential if you consent. We shall own the photos and recordings.
Do you agree to be photographed or videotaped before, during, and after treatment? (Bikini top) merely the top of the bikini.
YesNo
Do you agree to be photographed or videotaped before, during, and after treatment? (Browse, arms, legs, and torso)
YesNo
Are you under 18 age?
YesNo
Your Signature
Clear
Date
MonthDayYear
Date
Parents/ Guardian Signature
Clear
Date
MonthDayYear
Date
Should be Empty:

Sugaring Intake Form

Media Release