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Sugaring/Facial Consent Form

We have the right to refuse services for all waxing if proper hygiene has not been followed (showered and thoroughly cleansed front to back) or if we feel there is risk of contraindication from information provided written or verbal. 


 

I understand that if I have Herpes or Staph/MRSA, I may experience an outbreak after the sugaring service.


 

I understand I may carry Herpes and/or Staph/MRSA without any physical symptoms or a medical diagnosis. 


  

I also understand that a sugaring service does not allow the opportunity to contract these conditions from my technician. 


 

I understand all of the above mentioned reactions. I also understand if I change my skincare routine or medications, including OTC meds and vitamins, I must inform the professional PRIOR to any service in the future. 


  

I understand that with all treatments certain risks are involved and that any complications or side effects from known or un-known causes could occur. I freely assume these risks. 


  

I understand that if I cancel or miss my appointment within the 24 hour cancellation policy I will be charged the FULL SERVICE FEE. 


 

If you have any questions regarding your sugaring service please call or text me first. Do not believe everything you read on the internet. Do not ask your friends, they are not professionally licensed, experienced or educated in professional sugaring services.

Post care: nothing that causes you to sweat; no tanning beds; no lakes, pools, spas or saunas; no lotions, creams or serums, and no exfoliation for 24 hours.

Date: December 5, 2025

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information
Newsletter:*
No
Yes
How Did You Hear About Us?
Have you been sugared or waxed before?*
No
Yes

Do you have any tendencies towards: 

Ingrown hairs*
No
Yes
Break outs*
No
Yes
Bumps*
No
Yes
scarring*
No
Yes
bruising*
No
Yes
hyperpigmentation*
No
Yes
eczema*
No
Yes
psoriasis*
No
Yes
Have you received a recent chemical exfoliation such as a glycolic peel or other AHA treatment in the last 7 days?*
No
Yes
If yes, when?
Have you applied any topical products containing glycolic, lactic or salicylic acid, lightening or bleaching gels in the last 7 days? *
No
Yes
If yes, when?
Have you had microdermabrasion, laser resurfacing, light therapy or injectable treatments in the last 7 days?*
No
Yes
If yes, when?
Are you taking acne drugs or using exfoliating topical products such as Retin-A® or other Vitamin A products?*
No
Yes
If yes, when?
Have you had continuous exposure to the sun, shaved, scrubbed or experience recent peeling or irritation in the last 48 hours?*
No
Yes
If yes, when?
Skin treatments:
Dates:
Products currently using on face and neck:
Medical Conditions:
Herpes virus *
No
Yes
Staph/MRSA *
No
Yes
Allergies*
No
Yes
Medications in the last 8 weeks including OTC drugs & vitamins:
Pregnant or lactating?*
No
Yes
Under a dermatologist’s care now or recently?*
No
Yes
Name of Doctor:
Date Last Seen:
Allergies to products or medications:
History of fever blisters or cold sores? *
No
Yes
Tanning regime or use of tanning booths? *
No
Yes
Frequency:
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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