top of page

Confidential Waxing Questionnaire

Thank you for choosing Perfect Peach Waxing for your waxing services. To provide you with the safest and most gentle waxing experience, please complete this questionnaire honestly.

If no, which waxing service/services have you had before?
Are you on any of the following medications now or in the past year?

* If yes, please understand that waxing within the first 7 days of fillers or Botox can change or lessen your results.

Do you currently have or have you had any of the following in the last 12 months?

* I understand that I may be asked to have a patch test prior to my full
waxing service.

If you have any other questions or concerns please feel free to let me know.

By providing my signature below, I confirm that the above information is complete and accurate to the best of my knowledge. I have given an accurate account including all known allergies, prescription drugs or products I am currently ingesting or using topically. I understand that Perfect Peach Waxing may only perform treatments within their scope of practice and level of comfortability. Anything discussed during my session shall not be regarded as medical advice, treatment, diagnosis or prescription. I fully understand that Perfect Peach Waxing may refuse service at any time for any reason and that certain medical issues may contraindicate some waxing services and I will be asked to seek out a medical professional for advice. I  understand that it is my responsibility to inform the technician of any changes to my medical profile or skincare routine at every visit. The technician and Perfect Peach Waxing will not be held liable for any liability resulting from my treatment. I agree that I have been given sufficient opportunity to ask questions and make specific requests in order to make my treatment time as comfortable as possible. I have also read and will aid by all policies and client expectations that are listed separately from this document. I agree that this constitutes full disclosure and I understand the
procedure and accept all risks.

Perfect Peach Waxing Services Signature Release

In order to give you the most professional and safest services possible, we ask that you read and completely understand the following Release Form. If you have any questions at all, please ask a Perfect Peach Waxing technician to assist you with understanding this form. I thank you for helping us provide the safest and highest quality services today. The term “service(s)” will represent all Perfect Peach Waxing removal services for the remainder of the document.

I understand that the service(s) that I elect to receive today may cause allergic and/or harmful reactions. I realize that I may have allergic and/or harmful reactions to waxing/spa/salon/cosmetic services or products that may include but are not limited to redness, rash, swelling, hives, skin coming off with the wax, wax burns, scabbing, bruising, skin tearing, etc. With full knowledge and understanding of the risks involved., I do want my requested service(s) performed today. I assume all risks associated with my election to have this/these service(s) performed and release any person, business or corporation T/D/B/A

Perfect Peach Waxing and its representatives from any and all liability associated with the service(s) including but not limited to personal injury. This release is given without limitation. I acknowledge that I fully understand all risks rendering chosen service(s). I also understand that no service(s) will be performed without my having filled out the Confidential Waxing
Questionnaire. It is to be updated and reviewed before any and all Service(s). Information that I provide on the Questionnaire will give the Representatives the right to any or all services. I also declare that I am not suffering from and type of contagious disease that would put Perfect Peach Waxing representatives in harms way. I will inform my technician of any and all

If I am under 18 years of age, my parent or legal Guardian’s signature is required below.  
This Release is in effect for all current and future services.

* If you are a MINOR (under the age of 18), please provide the following information.  If you are not a minor, continue to "SUBMIT" button.

Are you signing as the parent/guardian and or responsible adult for the client who is under 18 years of age?

* In consideration of (minors name above) being permitted by Perfect Peach Waxing to participate in its services including but no limited to, waxing services. I agree to indemnify and hold harmless Perfect Peach Waxing, LLC from any and all claims which are brought by or on behalf or minor, and which are in any way connected with such services by minor.

Thanks for submitting! We will contact you soon!

bottom of page