Waxing Consent Form

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I give consent to the service provider to perform waxing hair removal treatment. I have not used a scrub, Retin-A, Retinol OTC, take home micro-dermabrasion, glycolic peels, other peels, exfoliated or tanned in the last 14 days. I have been off of Accutane for at least twelve months. Some possible side effects include redness, swelling and pimples, but these are temporary and generally fade within 72 hours. For Brazilian and/or bikini waxing, I will notify my service provider if I am on my menstrual cycle. I do not have any open skin lesions or active herpes outbreak (cold sore or genital). I understand that with treatment certain risks are involved and that any complications or side effects from known or unknown causes could occur. I freely assume these risks. I agree to adhere to all safety post care including: no peels, tanning or wet room services; no swimming/spas/hot tubs for 72 hours after waxing; and all home skin care protocols as recommended by my service provider. I am over 18 years of age or I have parental consent co-signed below. I understand results may vary and it may take multiple treatments to get desired results. I understand there are no refunds on any service provided. I will call to inform my service provider of any complications or concerns I may have as soon as they occur. I agree to allow pictures to be taken and shared of me. I acknowledge that the technicians at Adore are trained professionals committed to maintaining a high standard of professionalism. I agree not to engage in any behavior that may compromise their professional environment. I commit to treating the technicians with respect and courtesy. I understand that any inappropriate behavior, including but not limited to comments, actions, noises, and bodily fluids, that make the technician uncomfortable will not be tolerated. I understand if I make the technician uncomfortable by being inappropriate, the service will be ended immediately, and I will be charged the full price of the service and will no longer be allowed at Adore. My signature acknowledges that I have read and agree to receive the treatments or series of treatments listed above and that I will adhere to all of the aforementioned statements that I have initialed. This agreement will remain in effect for this procedure and all future procedures conducted by Adore. I have read and fully understand all information in this agreement.

402 669 7094

By Appointment Only

4935 S 136th St, Omaha, NE, 68137

Waxing Consent Form

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