Before your appointment

Service Consent Form

A few details help us tailor your visit with care. Please complete this form before your service at Rozy's Threading & Waxing Studio.

Your appointment details

Fields marked with an asterisk are required.

Full name *Phone number *Email address *Appointment date *Service *

Health & allergies

This tells your stylist which products are safe to use on you.

Have you ever had an allergic reaction to hair color? *

YesNo

Any other allergies or medications we should know about

Services agreement

Form updated 06/2024

Scroll through the full agreement below, then tick the single box underneath to confirm you have read and accept all of it.

A signed copy of this form is kept in our files for future reference and gives us your consent to perform any of our services now and in the future.

Before and after your service

I have not used a scrub, Retin-A, Retinol OTC, take-home microdermabrasion, glycolic peels or other peels, and I have not exfoliated or tanned in the last 72 hours.
Some possible side effects include redness, swelling and pimples. These are temporary and generally fade within 72 hours.
I do not have any open skin lesions or an active herpes outbreak (cold sore or genital).
I understand that with treatment certain risks are involved and that any complications or side effects from known or unknown causes could occur. I freely assume these risks.
I agree to adhere to all safety post care including: no peels, tanning or wet room services, and no swimming, spas or hot tubs for 72 hours after waxing. I also agree to perform all home skin care protocols as recommended by my service provider.
In exchange for performing the requested services, I hereby agree to release Rozy’s Threading & Waxing Studio, its employees, managers and suppliers from any or all damages and injuries which may result from the treatment or treatments I have requested.

Threading · Skin care · Waxing · Lashes · Hair removal · Tinting

I understand that the treatments I have requested may involve the application of sanitary chemicals which may cause irritation to my skin. I am not currently using any Alpha Hydroxy products, chemical peels or bleaching creams and have not done so for 30 days. I have also not been tanning within the last 24 hours and do not plan to tan within the next 24 hours.
Please note: Waxing does have certain side effects such as skin removal, redness, swelling and tenderness.
I have read the above information and if I have any concerns I will address these with my skin therapist.
I give permission to my therapist to perform the procedure we have discussed and will hold her and her staff harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above, including all known allergies, prescription drugs and products (including over-the-counter) I am currently ingesting or using topically.
I understand my skin therapist will take every precaution to minimize or eliminate negative reactions as much as possible. I have read and understand the post treatment home care instructions, and I am willing to follow the recommendations made by my skin therapist for a home care regimen. If I have additional questions or concerns about my treatment or suggested home care, I will consult my skin therapist immediately.
I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I certify that I have read and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks.
I do not hold the skin therapist responsible for any of my conditions that were present but not disclosed at the time of this procedure and which may be affected by the treatment performed today.
Although every precaution will be made to ensure my safety and well-being before, during and after a tinting application, I am aware that some irritation, itching or burning may occur to the skin which comes in contact with the tinting agent.

I have read and understand every statement in the agreement above, I have had the opportunity to ask questions, and I voluntarily agree to receive the selected service. *Electronic signature *My signature acknowledges that I have read and agree to receive the treatments and services listed above, and that I will adhere to all of the statements in this agreement. Type your full name to sign.

Hygiene policy: we have the right to refuse all waxing services if proper hygiene is not followed. For Brazilian and bikini waxes, please use the provided wipe to cleanse the area.

Where this goes: your completed form is emailed to the studio and kept with your record. Once you submit, you can download a signed PDF copy for yourself.