Waxing Consent Form Template

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A Waxing Consent Form is an agreement between a salon or esthetician and a client acknowledging the risks and granting permission for treatment. It is used to protect service providers from liability and confirm client awareness before the procedure.
Waxing Consent Form

This Waxing Consent Form (the "Form") is entered into on   (the "Effective Date").

Client's details

Full name:   (the "Client") 

Address:  

Gender:  

Please note that by signing this Form, you declare that the answers given herein are true and complete to the best of your knowledge. False or misleading answers can lead to complications or undesirable results.

Waxing procedure

I voluntarily consent to undergo a waxing procedure chosen from the list above provided by: 

Waxing services provider's details

Name of the waxing professional:  , an individual registered at  .

The waxing services are provided at  . 

Side effects. I understand and acknowledge the following regarding the waxing procedure:

• Waxing involves the removal of hair by applying and removing hot wax, which may cause temporary discomfort, redness, and sensitivity in the treated areas.

• Possible outcomes may include mild irritation, redness, or ingrown hairs following the waxing procedure. Waxing may cause inflammation, welts, hives, lifting skin, reddening, or small breakouts. 

•  

The above list of side effects is not exhaustive. Contact us if you experience severe or prolonged side effects.

This Form can be used for a one-time procedure.

Questionnaire

What type of skin do you have? 

  •  

Do you have any skin infections?

  •  

Do you have any concerns? 

  • No

Are you pregnant, diabetic, or receiving cancer treatment? 

  •  

Do you have AIDS, lupus, or other chronic condition(s) that may compromise the skin barrier? 

  •  

Are you taking antibiotics, birth control, or hormone replacements? 

  •  

Do you have any allergies, including allergies to wax or latex? 

  •  

Have you recently received any exfoliating treatments or chemical peels? 

  •  

 

  •  

I have provided accurate information and answers to the questions above that might affect the waxing procedure.   

Waiver. Except in cases of proven gross negligence or willful misconduct, the waxing services provider shall not be liable for any claims, damages, losses, or injuries, including but not limited to those arising out of or related to personal injury, skin reactions, or other adverse effects resulting from the waxing procedure. 

I acknowledge that there are risks involved with the waxing procedures, including, but not limited to the side effects listed above. I agree that any false or incorrect information I have given in the questionnaire may lead to undesired results and complications and hereby waive the liability of the waxing services provider if such results or complications arise.

I have been informed of the aftercare instructions and will follow them to minimize potential complications.

I have carefully read and understood the information provided above. I hereby give my consent to   to perform the specified waxing procedure. 

Client's signature: _____________________

Client's full name:  

Date:  

Written by Megan Thompson - Reviewed by Kate Adkham

Template Description

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Paper titled "Waxing Consent Form"; female massage therapist talking to a female client lying on the coach
Before creating the document...

Please note that this form may be issued on the letterhead of the waxing services provider.

A waxing consent form has the role of protecting both the service provider and the client interested in this treatment. A well-crafted consent form will inform the client about the procedure, the process, and some of the potential drawbacks. 

If you provide waxing services, knowing how to properly design a consent form for waxing is paramount so your business is fully protected.

When to Use a Waxing Consent Form

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A waxing consent form can be used for:

  • Face waxing

  • Eyebrow waxing

  • Leg waxing

  • Brazilian waxing

  • Sugaring

  • Strip waxing

  • Hot or cold waxing

If a treatment uses wax to remove hair, you should create a waxing consent form and give it to the client.

Parties of the Waxing Consent Form

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A waxing consent form features two parties:

  • The service provider: This is the business or individual providing the service, in this case, the waxing treatment. 

  • The service receiver: The person benefiting from the treatment, or the client, is the service receiver. However, if the client is a minor, they cannot sign the waxing consent form, so a parent or legal guardian will need to sign it for them. 

Key Terms

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Typically, a waxing consent form will include:

  • The full names of all the parties involved;
  • Questions to assess the client's history;
  • Disclaimer regarding the potential side-effects of waxing;
  • Aftercare steps the client should follow; and 
  • The signatures of both parties.

How to Write a Waxing Consent Form

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A good form focuses on certain details to ensure your and your client's protection. When you start crafting this document, make sure that your waxing consent form template includes:

1. Client's Details

A waxing consent form template usually begins by asking the client for relevant personal information, such as:

  • Full name

  • Date of birth or age

  • Gender

  • Address

  • Phone number

  • Email

The consent form for waxing can also ask for the information of a third party to contact in case of a bad reaction or medical emergency.

2. Details About Any Allergy

When creating your consent form for waxing template, ask about any skin allergies or sensitivities the client might have: 

  • Allergies to substances/products commonly used in waxing

  • Level of sensitivity regarding bruising, scarring, burning, or other adverse skin reactions 

  • Existing or previous skin conditions such as eczema or hyperpigmentation

Don't forget to also include information about the products and substances used. A comprehensive consent form for waxing will benefit both you and the client.

3. Medical Care History

You should also include questions about the client's medical history relevant to the waxing procedures. Some specifics to add to your waxing consent form include pregnancy, estimating the next menstrual cycle, varicose veins, diabetes, and prescription medications.

4. Current Medical Condition

The waxing consent form should ask the client whether they are still dealing with the previous medication conditions or following their treatment. It can be an open question asking the client to describe their health.

5. Recent Treatments Causing Sensitivity

Some treatments can cause skin sensitivity, which complicates the waxing process. You can include questions in your waxing consent form about:

  • Skincare treatments such as chemical peels

  • Tanning sessions (both in natural sunlight and a tanning bed)

  • Medications known to cause sensitive skin, such as acne treatments or antidepressants

Warning

The after effects part of the waxing consent form will list what effects the client may expect after the procedure, which can include:

  • Skin irritation and redness;
  • Minor swelling;
  • Ingrown hairs;
  • Allergic reactions to chemicals;
  • Skin bruising, and
  • Sun sensitivity.

6. Risk Factors or Side Effects

Apart from the after-effects listed above, the waxing consent form should also list additional potential risk factors and side effects to give clients the full details of what to expect.

Regarding risk factors, you may detail in your waxing consent form template some pre-existing conditions or post-treatment behavior that could lead to unwanted side effects, such as undisclosed skin treatments or not following aftercare properly.

Insight

You should also include in your consent form for waxing a few recommendations for after the treatment. 

By doing so, you protect yourself, and you also improve your relationship with your customers, as it shows that you are caring about their well-being. For example, mention in your waxing consent form:

  • How to keep the waxed area clean;
  • Products and activities to avoid;
  • How to soothe the skin;
  • Type of clothes to wear right after the session and
  • How long post-waxing aftercare should last.

7. Client's Signature or Consent

Before the client signs the waxing consent form template, add one or two lines that state they have read the form and agree to all the terms. 

This text should show that the client:

  • Read and understood the waxing consent form

  • Agrees to treatment and aftercare

  • Will not hold the technician liable in case of an adverse reaction

8. Parent's or Guardian's Consent

If you have a client who is under 18, you should know that they can get waxing treatment, too. But, they need to be accompanied by a parent or guardian who can consent for them. 

Have a waxing consent form prepared that includes information about the parent, too. Make it clear that the parent is the one agreeing and consenting to the terms of the form on behalf of the child. 

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