Private Waxing & Skincare • Lehigh Acres, FL
Intake + Waiver Takes ~3 minutes

Client Intake Form & Waiver

All information is confidential and required to ensure your safety and the quality of your service.

1) Client Information

Required for every appointment.

Preferred method of contact *
First visit with us? *

2) Service Selection

Select what you’re coming in for. This will personalize the form.

Tip: If you’re doing multiple services, check all that apply.

3) Skin Information

Helps us tailor the service safely.

4) Health & Skin History

Required for safety. Please answer honestly.

General Health (check all that apply)
Skin & Infectious Conditions (check all that apply)

⚠️ Active outbreaks or open lesions may require rescheduling for safety reasons.

Waxing Consent

I understand that waxing may cause temporary redness, irritation, ingrown hairs, bruising, or skin lifting if contraindications exist. I confirm I am not using restricted medications or treatments unless disclosed.

Facial Treatment Consent

I understand that facials may include exfoliation, extractions, enzymes, or active ingredients that may cause temporary sensitivity, redness, or purging.

Eyebrow Services Consent

I understand that brow waxing, tinting, or shaping may cause temporary redness or irritation and results may vary depending on skin type.

5) Waiver & Consent

Please read and confirm.

By signing below, I acknowledge that waxing, facials, and skincare treatments may cause temporary redness, irritation, ingrown hairs, sensitivity, or mild discomfort. I understand results vary based on skin type and aftercare.

I confirm I have disclosed all relevant medical conditions, medications, and skin concerns. I understand services may be refused or rescheduled if undisclosed conditions pose a risk. I release Beauty Boosterr, its owner, and staff from liability for adverse reactions resulting from undisclosed information or failure to follow aftercare instructions.

Photography Consent (Before & After)

I understand that photos or videos may be taken before, during, or after my service for documentation, educational, and marketing purposes.

Your decision will not affect your service in any way.

Signature

Sign with your finger/mouse.

Not signed

This form is stored securely and used only for client care and safety. If you have questions, contact us.