Release Form

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Waxing/Health History

Please check all that apply

Have you had waxing done before?
Have you ever experienced any reaction or breakout from waxing?
Have you used any products in the area(s) to be waxed?
Do you currently use sunscreen?
Do you currently tan (Indoors or Outdoors)?
Do you develop cold sores/fever blisters?
Is your menstrual period due within the next week?
Have you ever used Renova, Differin, or Tazorac?
Have you ever used Retin-A?
Have you ever used any topical medications or AHAs?
Have you ever used Accutane?
Have you recently had a Microdermabrasion
Have you recently had a chemical peel?
Have you ever had laser treatments?

I understand that I must avoid direct sunlight for at least 24 hours and wear at least SPF 25 for 48 hours post-treatment.  I further understand that some redness, irritation, ingrown hairs, and small white bumps may occur and that waxing may stimulate the activity of cold sores and fever blisters.  I understand that the aftercare instructions given will be followed and Rio Premier Waxing Studio will not be held liable if performed otherwise.  I understand the procedure of waxing and/or Brazilian wax, that will be performed during my appointment, and I will not hold Rio Reinhardt or any other staff member and "Rio Premier Waxing Studio" or any affiliates liable for any type of reaction that may occur.  I agree to not take any video or pictures while I am in the Estheticians room.  I am at least 18 years of age or have a parent or guardian present.

By checking this box, I understand everything I have read above.
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Rio Premier Waxing Studio

3807-L South Peoria Avenue
Tulsa, OK 74105
Phone: 918.895.6514
Email: riopremierwaxing@yahoo.com


By Appointment Only