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• Waxing Booking Form

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• Date
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• Client Name*
• Address*

  Street Address 1

  Street Address 2

  City

  State/Province/Region

  Postal/Zip Code

  Country
• Phone*

  --
• Email*
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• Are you new to waxing treatments?*

  Yes No
• During past waxing treatments, did you have any adverse reactions?*
  No Yes

  Please describe any adverse reactions.
• Which waxing services are you seeking?* Select Eyebrow Full Leg Half Leg Arms Knuckles/Toes Underarm Chest Bikini Brazilian Full Face Back Stomach Butt Inner Thigh Upper/Lower Lip Sideburns Ears Nose Hairline
• Current Medical Conditions* Select Allergies Diabetes Epilepsy/Seizures Heart Condition Hypertension
• Please list any allergies.*
• Date of most recent waxing.*
• Preferred Date*
• Preferred Time*

  :AMPM
• Comments
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