Name
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First Name
Last Name
What are your pronouns?
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Email Address
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City & Zip-code
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Phone
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(###)
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####
Date of Birth
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MM
DD
YYYY
What do you value the most? A: Stability, Structure, Planning, Rules. B: Freedom, Flexibility, Excitement. C: Relationships, Teamwork, Community. D: Learning, Logic, Research, Accuracy.
List below any known skin allergies and skin sensitivities to products or ingredients.
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Any cold sores breakouts today or recently? (Herpes Simplex I)
*Please know, any face waxing services or facial treatments will NOT be performed on anyone with a current cold sore breakout until your breakout is completely healed and gone*
Are you Pregnant?
Acne problems?
List any Antibiotics you currently taking, any prescriptions for Acne you currently using (topical acne creams, oral or antibiotics). Any advanced Anti-aging skin lines you currently use or Retin-A prescriptions. Please write the name of the brand, prescription and the strength of the medication. *If None, please type None*.
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Are you under a dermatologist's or a doctor’s care?
If yes, explain:
Do you currently use any of the following medications or products with any of the following ingredients?
If yes, how long and how often do you use these products? Please list the medical name and strength. If you took any of these in the past, when was the last treatment? Use this space to explain:
Please note, do not expose skin to the sun or tanning beds for at least 48 hours after any waxing service or advanced facial treatments. Please use SPF products, 30 minutes before sun exposure to prevent discoloration.
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Any past skin reactions after a waxing service or a facial treatment?
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If yes, please explain:
What type of services are you looking for?
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Have you been waxed before? Any skin concerns?
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Are you taking blood thinners? Do you take an aspirin daily or often? Please use the space below to explain further. If NO, please type no.
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Please check any that apply to you:
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*Please use this space below to write any additional information for any of the questions listed here*
Common Cold & Flu Policies
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*Do you have any type of cold symptoms or was sick recently? (Even with a regular, common cold).
*Do you currently have or recently had, a fever, any respiratory, flu symptoms, sore throat, or shortness of breath?
*Are you feeling 100% healthy, with no cold or flu symptoms or congestion of any kind?
If any of the these questions apply to you, please use the box below to further explain.
Please know if you show any symptoms of being sick in any way, you'll be asked to reschedule for another day.
Since COVID-19, we have increased our sanitation and disinfecting practices and we are taking extra precautions before and after each client. We will review your health history and ask health questions before we can see you at our facility.
Please don't bring anyone with you during your appointment. Other people or kids are NOT allowed in the room.
Symptoms of being sick and COVID-19 include: Fever, Chills/Shakes, Difficulty Breathing, Dry Cough, Sore Throat, Sneezing, Body aches, Skin Rashes, Sudden loss of taste or smell.
*If this doesn't apply to you today, please type Healthy*
Cancellation & Deposit Policies
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These policies apply to new and existing clients at all times and for every visit.
Please notify me 48 hours in advance (before your scheduled appointment time), if you need to change, cancel, modify or reschedule your services in order to avoid the booking fees listed below. You can call, text or email me.
I respect your time and schedule and I hope you do too. I try my best to accommodate you but sometimes it’s not possible.
*A deposit is required in order to schedule an appointment at my studio.
If you book online, the same policies are listed there.
For any missed appointment, late cancellation/modification, late arrival (more than 5 minutes) or a ‘no-show’:
*A booking fee equal up to 50% of all the scheduled services you missed that day is required in order to book an appointment at my studio again. This applies to clients that have prepaid waxing series as well.
*All booking deposits are non-refundable if you miss or cancel an appointment with less than 48 hrs notice. No credits for future services or refunds will be given.
*The promotional value/discount of any pre-paid series expires after 2 months of inactivity (last appointment at our studio), please use them accordingly. If your series are expired, I will calculate the full fee of each service you used so far, and give you a refund based on the amount you prepaid.
I have read, I understand and I agree with these Spa Policies for this visit and for all future visits.
*PLEASE TYPE YOUR FULL NAME BELOW*
