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Waxing Consultation Form

  /  Waxing Consultation Form

    This Consultation Form will assist your therapist in correctly evaluating your needs & to personalise your treatment for you today. All information is strictly confidential & remains the property of ZahMal London LTD.

    Have you ever had a wax before? :
    Yes (Please select type)Under armFull legHalf legBikiniHollywoodBrazilianFaceOtherNo (Never had a wax before)

    ♦ Please indicate any recent or current experience with any of the following:

    BODY SECTION :
    DiabetesEpilepsyOedemaPsoriasisSunburnMolesPregnancyNew Scar TissuePoor CirculationVaricose VeinsPrescribed MedicinesHypersensitive SkinUndiagnosed Lumps and BumpsPhlebitisNone
    Do you use any of these products? :
    Retin AGlycolic AcidAccutaneOedemaNo

    Please list any other physical or health conditions that your therapist should be aware of:

    Please list any medication taken regularly and any specific medication/pain killers taken today:

    Please list any allergies:

    Any notes or requirements?:

    How did you hear about us? Word of MouthInternetPop upAdvertising
    Please agree to our terms and conditions below
    I confirm that to the best of my knowledge, the answers I have given are correct and I have not withheld any information that may be relevant to my treatment. I certify that the preceding medical, personal and skin history statements are true and correct. I am aware that it is my responsibility to inform my Therapist of my current medical or health conditions and to update this history as a current medical history is essential her/him to execute appropriate treatment procedures. I understand that ZahMal London LTD. reserves the right to charge for appointments cancelled or broken without 24 hours notice.

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