Waxing & Consent Form

Please fill out this form.
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?
Are you currently taking Accutane or have you taken it in the past?
Do you take any medication?

Please notify me of any allergies prior to your service/procedure.

I understand there are risks associated with an eyebrow tint. I further understand that as part of the procedure, eye/skin irritation, eye/skin pain, eye/skin itching, discomfort, and in rare cases infection or blurriness could occur. I agree that if I experience any of these medical conditions with my eyes, lashes, or skin that I will contact my technician and consult a physician at my own expense.

I understand that even though my technician waxes and tints using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and solutions used may irritate my eyes and/or skin and may require a physician’s follow-up care.

Thanks for submitting!