CLIENT CONSULTATION FORM

MEDICAL QUESTIONNAIRE

If yes to any of the above, please give details:

Please follow the guidelines below to ensure your skin is cared for properly post wax.

• Avoid hot baths and showers for 48 hours

• Avoid saunas and steam rooms for 48 hours

• No exfoliating the area for 48 hours

• No sunbathing or sunbeds for 48 hours

• Avoid exercise / activity that causes sweating for 24 hours

• Avoid swimming pools for 48 hours

• Avoid perfumed products on the area treated.

DISCLAIMER

I have read the above information and if I have any concerns, I will address these with my therapist. I give permission to my therapist to perform the treatment we have discussed and will hold them harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically. I understand that my therapist will take every precaution to minimise or eliminate negative reactions as much as possible.

I have read and understood the post - treatments home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negotive reactions.

I agree that this constitutes full disclosure and that supersedes any previous verbal or written disclosures. I certify that I have read and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the esthetician responsible for any of my conditions that were present, but not disclosed at the time of the skin care procedure, which may be affected by the treatment performed today.