Waxing Client Intake Form

Full Name

Birthday

Month

Day

Year

Do you have any of the following conditions? (Check all that apply)

Do you have any allergies or sensitivities to latex, wax, rosin, fragrances or essential oils, medications, foods or skin products/ingredients?

Are you currently taking any of the following?

Have you had any of the following in the past 2 weeks?

Do you currently use any of the following in the area being treated?

Chemical exfoliants (AHA, BHA, glycolic, salicylic)

Benzoyl Peroxide

Acne medications (oral or topical)

Self-tanning products

I understand that waxing may cause minor skin lifting, redness, irritation, allergic reaction, bruising, or ingrown hairs. I have disclosed all medical conditions, medications, and skin care products to the best of my knowledge.

Waxing Intake Form

Waxing Client Intake Form

The Nest Beauty Services

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