New Client Form

Name *
Name
Date of Birth *
Date of Birth
Address
Address
Phone *
Phone
Have you shaved within 10 days of your appointment date? *
Are you currently using or have you used any of the following in the past 7 days?
Check all that apply.
Do you have tendencides towards any of the following?
Check all that apply
Are you taking Accutane (or similar) or have you in the past year? *
Brand names include: Accutane, Claravis, Sotret, Accutane, Amnesteem, Myorisan
Accutane Warning: *
Using retinoids (accutane or similar) can cause skin to rip off during the waxing process. For your own safety, we cannot wax you until you have been off of Accutane or similar medications for over a year's time.
By clicking submit, you certify that all information contained herein is accurate to the best of your knowledge and that you have withheld nothing in the online consent form for Sugar Me Wax. You also agree that you have read and agree to our liability waiver, holding Sugar Me Wax harmless from all liability for ALL services found on our menu (including but not limited to waxing, sugaring, skin care, micro-needling, microdermabrasion, chemical peels and facials). Please read the liability waiver fully by clicking here. Once you have completely read the liability waiver, type your name into the box below to give consent that you agree with this liability waiver and certify that the information above is accurate.
Date
Date