Please feel free to print out, fill in and bring to your consultation to save you time
The following information is required for your health and safety
Date of birth:
Drs name: (Your Dr will not be notified without your written consent)
It is vital that you inform me of any medical issues, as certain conditions mean you cannot be waxed. Please tick next to any of the folllowing if you have them
Medications/under care of a Dr
Sunburn or heat allergies
Use of steroid creams or medication that thins the skin
Use of vitamin A skin care, glycolic acid or other AHA/BHA products
Use of roaccutane or acne treatments
Recent dermabrasion or laser treatment
Allergies to nuts, essential oils, lanolin, sticking plasters etc.
Oedema or other swellings in treatment areas
Other areas of tenderness to be avoided
Recent scar tissue, cuts, bruises to treament areas
Easily bruised, sensitive or highly reactive skin
Epilepsy, fits or fainting attacks
Low blood pressure
High blood pressure
Joint mobility issues
PREVIOUS REACTIONS TO WAXING
I confirm that the information given above is correct and complete, and give consent to the therapy I am receiving. I have read and understood the pre care and after care advice and the possible temporary reactions that may occur with a waxing treatment, such as bloodspotting, sensitivity, skin removal, and the possible reactions with a massage, for example. I will follow the advice given by my therapist, and if any major issues occur, to seek medical advice.
These details will be kept confidential under the data protection act.