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PureWax and Beauty

Waxing Consent Form

Personal Information

Full Name

Date of Birth

Must be 18 years old; ID will be checked if you look younger than 18.

Phone Number

Email Address

Referral & DIscovery

How did you find us?

Did someone refer you?

Skincare Products

Select which ever applies Required

Stop two weeks prior

Stop 7 days prior

Stop 1 year prior

Stop 2 weeks prior

Stop 2 weeks prior

Stop 3-5 days prior - may cause sensitivity

Medical Information & Contraindictions

Are you pregnant?

If due within 7 days I cannot service you, please reach out to your health provider.

Do you have or had any of the following conditions?

Select which ever applies Required

Client Requirements

  • At least 3 weeks of hair growth (~¼")

  • No shaving the area within the past 3 weeks

  • No fever or sickness on appointment day

  • Avoid caffeine & alcohol before service

  • Exfoliate 24–48 hrs before (not on appointment day)

  • No exercise immediately before/after

  • Avoid sun exposure 24 hrs after waxing

Salon Policies

Late Cancellations Policy​

If you cancel with 48–12 hours’ notice, we keep your deposit and you’ll owe a new deposit. If you cancel under 12 hours or same‑day, we keep your deposit and charge the remaining balance to the card on file.

Medical Disclaimer

I certify I have no current skin conditions (e.g. eczema), haven’t used Accutane in 12 months, no active sunburn/peels, and I’ve disclosed relevant history. I’ll inform PureWax & Beauty LLC of any changes.

Skin Care

No retinoids/AHAs 2 weeks prior or tretinoin 7 days prior; no lotions/creams on appointment day to avoid irritation.

Waxing Process

PureWax & Beauty LLC will explain risks, side effects, and steps to minimize discomfort.

Dispute Resolution

Disputes → negotiation → mediation → arbitration in Santa Clara County under California law.

Late Arrival Policy

Arrive on time; late arrivals may be shortened with full fee applied; 10% fee for delays over 5 minutes.

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Payment Policy

I understand PureWax & Beauty LLC does not carry change—if paying cash, please bring the exact amount.

Privacy Policy

PureWax & Beauty LLC will handle personal data per its privacy policy.

Service Modification Policy

To modify or remove services, inform us 48 hours before; otherwise you’ll be charged for booked services.

Period Policy

PureWax can wax you while on your period if you bring a tampon. If you cancel/reschedule due to period, standard cancellation policy applies.

Service Agreement

I,                                                                   understand waxing services involve hair removal from the root, may cause discomfort/redness/irritation, and these effects are normal and temporary. I agree to inform the esthetician of any medical conditions, allergies, or sensitivities.

I understand results vary and I’m responsible for maintenance appointments.

I consent to services and hold PureWax & Beauty LLC harmless for adverse reactions.

Signature

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