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Client Consultation Form

Name*

Email*

Phone*

Have you recently used any Vitamin A-based medications such as topical Retinol, Retin-A (Tretinoin), or oral Roaccutane (Isotretinoin)?*

Do you have any medical conditions that may affect your skin’s response to waxing (e.g. diabetes, epilepsy, autoimmune conditions, or cancer)?*

Do you have any allergies to wax, essential oils, colophony (resin), or other skincare ingredients?*

Have you had recent sun exposure, used sunbeds, or had a sunburn in the past 48 hours?*

Do you have any of the following skin conditions in the area to be waxed: eczema, psoriasis, rosacea, acne, dermatitis?*

Have you recently undergone any medical or cosmetic treatments or procedures in the area to be waxed? *

Are you currently pregnant or breastfeeding?*

Have you experienced any adverse reactions to waxing treatments in the past?*

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Manchester Wax, Pollard Street East, Manchester, UK

07749351450

CLIENT DECLARATION & DISCLAIMER

I can confirm that the information I have provided in the form is accurate to the best of my knowledge. I understand that waxing treatments may involve potential risks and side effects, including but not limited to:

Temporary redness, irritation, or swelling
Ingrown hairs
Minor bruising or skin sensitivity
Allergic reactions to products used during treatment
Skin lifting or loss (particularly if the skin is fragile or compromised)
Breakouts or blocked pores, especially on sensitive or acne-prone skin
Increased sensitivity to sunlight after waxing

I have informed my waxing professional of any relevant medical conditions, medications, or skin sensitivities. I understand that my therapist will take all appropriate precautions to ensure a safe and hygienic treatment, but I accept responsibility for any adverse effects that may occur due to the treatment or due to undeclared information.

Contact Us

Client Consultation Form

CLIENT DECLARATION & DISCLAIMER

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