Spa Release of Liability and Waiver
Client Intake
Are you under the care of a dermatologist?
Contraindications for sugaring hair removal
It is extremely important to read these contraindications before getting a service. Please be aware that spa services deeply exfoliate the skin.

Women may experience extra sensitivity up to a week prior to the beginning of their menses.

Moles, skin tags, sunburned, irritated or areas with open skin cannot be treated. We can, however, work around them.

You must wait a minimum of seven (7) days after any deep exfoliating service (light chemical peel, microdermabrasion) before waxing or sugaring.

Sugaring must not be performed if you have been in a tanning booth the same day.

Sugaring must not be performed if you have had laser skin resurfacing within the past year.

Sugaring must not be performed if you have had a physician administered peel within the past two (2) years.

Do you understand the contraindications listed above?
The following is a list of medications that may cause concern and a dermatologist should be consulted before treatment. Please have a doctor clear you for spa services if you are taking medications that thin the skin (such as Retin-A), blood thinners, or medications that cause you to be sun-sensitive. (This is not a complete list. Please talk to your doctor about any medication you are on and follow their advice.)
Please check any that apply.
Spa Release of Liability
By signing this Spa Release of Liability and Waiver, I am confirming that I recognize that there may be inherent risks associated with using certain equipment, utilizing the Spa facilities, receiving Spa treatments.

I acknowledge and agree that I am responsible for my own health; that the Spa associates and/or technicians are not health care practitioners and cannot be expected to diagnose and/or treat individual health problems. I understand that I am responsible for discussing any questions that I may have concerning my health conditions (if any) throughout any program or treatment at the Spa and, should health-related symptoms occur, I will cease my participation and inform Spa personnel of the symptoms.

In the event that I have reason to believe that medical clearance must be obtained prior to participation in any Spa treatments, I agree to first consult a physician and obtain written permission from a physician prior to the commencement of any program, treatment or activity.

By voluntarily choosing to receive Spa-related treatments and/or participate in Spa-related activities and programs, I warrant that to the best of my knowledge, I have no disability, impairment or ailment that prevents me from receiving such treatments and/or engaging in such participation.

Consequently, in light of the foregoing, I hereby release the Spa known as Dulcederm and waive any and all claims, liabilities, or damages for personal injuries that I may experience directly or indirectly from receiving treatments, utilizing the Spa facilities and/or participating in the programs or activities offered by the Spa.

Please list any allergies you may have or anything I should be aware of prior to performing services on you.
Please write "none" if you are not allergic to anything.
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How did you hear about dulcederm?
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By submitting this form you agree that you have read, understand, and have informed us of any concerns.
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