Waxing Consent Form Template

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Updated – 2025 /2026


Consent and Agreement

The information provided is intended solely as a general template for obtaining client approval before performing a waxing procedure. It does not substitute professional advice or personalized consultation. Users should adapt the content to suit their specific practices and ensure compliance with local laws and regulations. The use of this template is at the user’s own discretion, and no liability is assumed for any inaccuracies, omissions, or impacts resulting from its use without proper customization and review.


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This is a sample waxing consent form template. Actual terms may vary; please customize to suit your specific clinic and legal requirements.

Waxing Consent Form Template

Parties Involved:

Clinic Name: Radiance Beauty Spa
Address: 789 Beauty Lane, Los Angeles, CA 90001

Client Name: Emily Johnson
Address: 456 Maple Street, Los Angeles, CA 90002

Description of Waxing Treatment:

Application of waxing to the client’s eyebrows, legs, underarms, or other specified areas, performed by the licensed technician at Radiance Beauty Spa.

Consent and Acknowledgment:

I, the undersigned, acknowledge that I have been informed about the waxing procedure, including potential risks, contraindications, and aftercare instructions. I confirm that I am of legal age or have parental consent, and I agree to proceed with the treatment voluntarily.

Relevant Medical Information:

I have disclosed all allergies, skin sensitivities, or medical conditions that may affect the treatment. I understand that failure to do so could result in adverse reactions.

Rights and Responsibilities:

I understand that I can withdraw my consent at any time before the procedure. I agree to follow the aftercare instructions provided by the technician and to report any discomfort or adverse reactions immediately.

Los Angeles, ______________________

________________________
Emily Johnson (Client)
________________________
Jane Smith (Technician)