Body Sugaring / Waxing Form | Fearless Femme Beauty Company

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Body Waxing and Sugaring Consent Form

Client Information

Full Name

Birthday

Month

Day

Year

How did that experience go?

Services to be Provided

Please select one or both:

Body Waxing

Body Sugaring

Health History

Do you use Retin-A, Renova, or Retinol/Vitamin A derivative products for the body?

Yes

No

Have you used any alpha-hydroxy acid or glycolic acid products in the area you intend to have serviced in last 48 hours?

Yes

No

Unsure

Are you currently taking Accutane or have you taken it in the past?

Yes

No

If yes, how long?

Are you on any other medication?

Yes

No

If yes, please specify:

Are you exposed to the sun on a daily/regular basis or do you use a tanning bed?

Yes

No

If you are healing from sunburn in the area you intend to have services please let us know.

If yes, how often and when was the last time?

Do you have any topical allergies that you're aware of?

Yes

No

List of known allergies:

Please notify your esthetician of any allergies prior to your service.

Are you currently taking any medications?

Yes

No

If yes, please list:

Do you have any existing skin conditions or concerns?

Yes

No

If yes, please describe:

Lifestyle

Do you:

use saunas

exercise

sweat excessively

have oily skin

Is skincare important to you?

Absolutely

Not really

Do you have any piercings or healing tattoos in the area to be serviced?

Yes

No

If yes, please describe:

Do you wear makeup on a daily/regular basis?

Yes

No

Sometimes

Service Understanding and Consent

I, the undersigned, request and consent to the application of waxing and/or sugaring treatments to my body by the trained technicians of Fearless Femme Beauty Company.

I understand that waxing and sugaring involve the application of a sticky substance to the skin to remove unwanted hair and that there are inherent risks, including but not limited to skin irritation, allergic reactions, and discomfort.

I am aware that while waxing and sugaring are generally safe, there is a risk of side effects such as redness, swelling, bumps, bruising, or ingrown hairs.

I understand that certain medications and products, such as Retin-A, Accutane, or other skin-thinning agents, can increase the risk of adverse reactions

I acknowledge that exfoliation and moisturizing may help reduce the risk of ingrown hairs and other post-treatment issues.

I acknowledge that rare side effects may occur, and I agree to consult a physician if any adverse reactions persist.

I agree to follow any aftercare instructions provided by Fearless Femme Beauty Company to ensure optimal results and minimize potential risks.

Video and Photo Consent

Please choose one:

I consent to the use of photographs or videos taken during my service for promotional purposes, understanding that my identity will remain confidential unless otherwise agreed upon.

I do not consent to the use of photographs or videos for promotional purposes.

Client Acknowledgment

I have provided accurate and complete information regarding my health, allergies, medications, and skin conditions. I understand that withholding information may result in adverse reactions.
I agree to inform my esthetician of any changes to my health status or skin conditions prior to each service.
I understand that Fearless Femme Beauty Company reserves the right to refuse service to anyone exhibiting contraindications or not adhering to health and safety protocols.

Liability Waiver

I, on behalf of myself and my heirs, hereby release, waive, and discharge Fearless Femme Beauty Company, its owners, employees, and agents from any and all liabilities, claims, actions, or demands arising from or related to the waxing and sugaring treatments.

Signature

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Date

Month

Day

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