Professional Documents
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Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc. and anyone
showing signs of any skin irritation or similar problems cannot receive waxing services. Anyone having just received a
microdermabrasion treatment or an acid peel cannot receive waxing services to the same area. Anyone with a history of
HSV I or II should be aware that waxing services may cause an outbreak.
I have read the above information and if I have any concerns, I will address these with my skin therapist. I give permission
to my therapist to perform the waxing procedure we have discussed and will hold the therapist harmless from any liability
that may result from this treatment. I understand my therapist will take every precaution to minimize or eliminate any
negative reactions. I have read and understand the post-treatment home care instructions. In the event that I may have
additional questions or concerns regarding my treatment or suggested home product / post-treatment care, I will consult
the therapist immediately. I understand the procedure and accept the risks.
I release “Brow and Lash Specialist - Jessica Devereux” of any and all liability and wish to proceed with services by
the Technician.
E-mail: ________________________________________________________________________