I give permission to Joni Helmick to perform the waxing procedure we have discussed and will hold her harmless from any liability that may result from this treatment.

I understand waxing does have certain side effects and risks such as skin removal, redness, swelling, tenderness, etc. If I have any concerns, I will address these with my skin therapist. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

I have not used any Alpha Hydroxy Acid (AHA) or glycolic products in the past 48-72 hours nor am I using Retin-a, Renova or Accutane (an oral form of Retin-a). I am not using any other skin thinning products and/or drugs that would increase risks of waxing. I am not pregnant or nursing. 

I have read and understand the post-treatment home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding my treatment or suggested home product / post-treatment care, I will consult the esthetician immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered.