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Waxing Waiver Form Template

Streamline Client Consent with Our Waxing Waiver Form

Worried about liability when clients come in for waxing services? This waxing waiver form template helps you obtain essential consent while keeping your salon protected. You'll simplify the paperwork process, collect e-signatures effortlessly, improve client trust, and ensure compliance with legal requirements. Plus, the form is designed with WCAG-aligned labels for accessibility. Get started with the live template and see how easy it is!

Use this Template (FREE) Live Preview
Full name
Date of birth
Email address
Mobile phone number
Emergency contact full name
Emergency contact phone number
Areas to be waxed today
Please Specify:
If you selected Other, please specify the area
Date of service
Is this your first time waxing this area?
Yes
No
Not sure
Are you currently pregnant or breastfeeding?
Yes
No
Not sure
Do you have any allergies (e.g., wax, resins, latex, aspirin)?
Yes
No
Not sure
If you have allergies, list them
Do you have any of the following on the treatment area today?
Products used on the area in the last 7 days
Topical retinoids (e.g., Retin-A, tretinoin, adapalene, tazarotene)
AHA/BHA exfoliants (e.g., glycolic, salicylic acid)
Physical scrubs or exfoliators
None of the above
Not sure
Are you taking isotretinoin (Accutane) now or have you taken it within the last 6 months?
Yes, currently
Yes, within the last 6 months
No
Not sure
Are you taking blood thinners or medications that may increase bleeding or bruising?
Yes
No
Not sure
Have you had any recent treatments on the area in the past 2 weeks?
Chemical peel
Microdermabrasion
Laser or IPL
Cosmetic injections (e.g., fillers, neuromodulators)
None of the above
Not sure
Have you had significant sun exposure or used tanning beds on the area in the last 48 hours?
Yes
No
Not sure
Do you have a history of keloid scarring or poor wound healing?
Yes
No
Not sure
I have answered the questions accurately and will inform the provider of any changes to my health or medications.
Yes
No
I understand the potential risks of waxing, including temporary redness, irritation, sensitivity, ingrown hairs, skin lifting, and allergic reactions.
Yes
No
I consent to receive the waxing service today.
Yes
No
I agree to follow the aftercare instructions and understand that individual results may vary.
Yes
No
I release the provider and facility from liability for known and customary risks associated with waxing, except where prohibited by law.
Yes
No
I consent to the use of my photos or videos for marketing purposes.
Yes, I consent
No, I do not consent
If the client is under 18, I am the parent or legal guardian and provide consent for this service.
Not applicable
I am the parent/guardian and I consent
I am the parent/guardian and I do not consent
Type your full name as your signature
Signature date
Parent or guardian full name (if applicable)
Parent or guardian signature date (if applicable)
{"name":"Full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Full name, Date of birth, Email address","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration featuring a waxing waiver form template for FormCreatorAI article

When to use this form

Use this consent before any brow, lip, underarm, bikini, or body wax. It protects you and your clients by documenting contraindications, risks, and aftercare. It is essential for first-time visitors, returning clients with new medications, or anyone who recently tanned, peeled, or used retinoids. Add it to your online intake so clients finish it during booking with the Beauty saloon online booking form. If a client books a same-day facial, pair it with the Facial intake form to avoid conflicts like peels before waxing. It also helps with teen brow appointments that need guardian consent and with bridal packages, keeping a signed record that reduces liability and rework.

Must Ask Waxing Waiver Questions

  1. Do you have any skin conditions, allergies (rosin, beeswax, latex), or open cuts on the treatment area?

    This flags contraindications that can cause lifting, burns, or infections. If history is complex, you can capture more detail with the Skin care assessment form.

  2. Have you used retinoids, Accutane, AHA/BHA products, peels, microdermabrasion, or tanned in the last 2-4 weeks?

    Recent exfoliation or sun exposure makes skin fragile. Knowing timing lets you postpone or adjust technique and temperature.

  3. Are you pregnant, breastfeeding, or taking medications that thin blood or increase skin sensitivity?

    These factors affect pain, bruising, and healing. You can modify areas, choose gentle wax, or decline if unsafe.

  4. When did you last wax, shave, or use depilatories on this area, and what is your hair length now?

    Hair length impacts grip, breakage, and results. You can reschedule or trim to improve outcomes and avoid irritation.

  5. Do you understand the risks and aftercare, and do you consent to treatment today (parent/guardian if under 18)?

    Clear consent and aftercare acknowledgment protect your business and set expectations. For broader policies across services, consolidate with the Spa consent form.

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