I am aware of the side effects including, but not limited to: allergic reaction, irritation, redness, burning, swelling, soreness, bruises or bumps. **

I am aware certain medications and over the counter products can increase the risk of injury when combined with skin care services. I am not using any medications that may cause such injury/reaction. I will advise my esthetician if this changes. **

I have been off Acutane for at least 12 months and I am not using Retin-A, or any products containing Alpha hydroxyl, or doing any other skin thinning treatments. * *

If you are currently using any of the listed medications, waxing services cannot be performed. Ask your dermatologist for more information and direction on how long to discontinue use before waxing. - Accutane - Adapalene - Alustra - Avage - Avita - Azelex - Clindamycin - Differin - Doxycycline - Erythromycin - Isotretinoin - Madifloxicine - Metronidazole - Prednisone - Renova - Tazarotene - Tetracycline - Tretinoin * (I understand)*

Inform your esthetician if you are currently using any other medications/products listed below as they can possibly cause increased sensitivity and/or lifting of the skin. - Other acne medications not listed above - Oral or Topical Antibiotics - Blood-thinning medications - Autoimmune disease medications - Steroid Medications - Psoriasis, eczema, or other chronic skin diseases (I understand)*

Inform your esthetician if you have had Recent cosmetic or reconstructive surgery - Recent laser skin treatment - Severe varicose leg veins - History of cold sores or fever blisters (waxing can cause a flare-up) - Using hydroquinone - Recent surgical peel, microdermabrasion or chemical peel using glycolic, alpha hydroxy, or salicylic acid, or other acid-based products - Use of tanning beds within 24 hours of wax appointment * (I understand)*

I have not used a scrub, take home Microdermabrasion, glycolic peels, other peels, exfoliated, or tanned in the last 72 hours. **

I am over 18 years of age or have parental consent co-signed below. **

For Brazilian or bikini waxing, I will notify my esthetician if I am on my menstrual cycle. You can still get waxed on while on your menstral cycle but please wear a clean tampon to your appointment.  **

I agree to adhere to all safety post care including: no peels, tanning, or wet room services; no swimming, spas, hot tubs for 72 hours after waxing; and all home skin care protocols as recommended by my service provider. **

I do not have open lesions or active herpes outbreak (cold sore or genital.) **

I hereby consent to and authorize the estheticians at Tiger Lily Beauty Co. to perform waxing service(s) on myself. **