Wax Consultation Form
Email *
Name & Date *
Contact Phone Number and Email (My system sends out appointment reminders for you & special savings) *
Which form of communication is best for you? I’d love to keep you in the loop with monthly specials, sales , new products/ services & fun business updates! *
Address, City, State, Zip (I occasionally send out happy mail)
Emergency Contact & Phone Number *
Your Birthday Month/Day
How did you hear about Kendra Renee Holistic Skin Nutrition & Expert Waxing?
Clear selection
Have you ever been waxed before? If yes, when?
(If applicable) When is your menstrual cycle due? *for your own comfort, it is best not to wax 2 days before, during, and 2 days following your menstrual cycle.
Do you have any tendencies towards: Ingrown hairs, break outs, bumps, hyperpigmentation, bruising, scarring, eczema, psoriasis? If yes, please note.
The more I know, the better your results and the better I can serve you. Have you had or do you use any of the following (if yes, please note date.): Microdermabrasion, botox, fillers, laser resurfacing, LED light therapy, removal of skin cancer, active cancer, chemotherapy, tetracycline, isotretinoin/accutane, Retin-A, aplha or beta hydroxy acids, resorcinol, at home scrubs/peels, indoor tanning, hydroquinone,herpes, staph, MRSA, allergies, etc.
What did you LOVE about your last waxing experience, and what could you have lived without?
Knowing that home care is a big part of achieving beautiful & healthy skin after waxing, would you like to chat about how to maintain today's results and have the best waxing experience? *
Please read carefully and initial the following by checking each box. *
Required
Anything else you want to share? I love learning about my clients as it helps me provide superior customer service.
By hitting submit, you acknowledge that you are virtually signing your name. *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy