Hair removal (Waxing or Threading)

First name

Last name

Phone

SMS subscribe

Multi-line address

Country/Region

Address

City

Zip / Postal code

Please leave instructions for parking. FREE immediate parking is required as I am caring heavy equipment

Birthday

Month

Day

Year

Heart Condition

Yes

if Yes, elaborate more

High or low Blood pressure

Yes

if Yes, elaborate more

Diabetes

Yes

if Yes. elaborate more

Cancer

Yes

Bruises

Yes

if Yes, elaborate more

Loss of skin sensation

Yes

if Yes, elaborate more

Pregnancy

Yes

if Yes, Elaborate more

Epilepsy

Yes

Short answer

if Yes, elaborate more

Medical Odema

Yes

if Yes, elaborate more

Recent scars or surgeries (under 6 months)

Yes

if yes, elaborate more

Skin disorders

Yes

if Yes, elaborate more

Medications

Yes

if Yes, elaborate more

During chemotherapy or radiotherapy

Yes

if Yes, elaborate more

Allergies

Yes

if Yes, elaborate more

Sunburn

Yes

if Yes, elaborate more

Phlebitis

Yes

if Yes, elaborate more

Self tan

Yes

if Yes, elaborate more

I agree with terms and conditions and that the information I gave is true

Doctors note the requirement if medical condition or need adaptation to your treatment or upload proof of parking

Upload your file

Choose a file or drag and drop one here.

I agree to inform immediately, if my body temperature is getting higher than 37 °C, develop a chough or loose my sense of taste and smell in the last 2 hrs prior the treatment

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

Month

Day

Year

Hair removal (Waxing or Threading)

Multi-line address

Country/Region

Address

City

Zip / Postal code

Please leave instructions for parking. FREE immediate parking is required as I am caring heavy equipment

Birthday

Month

Day

Year

Heart Condition

Yes

if Yes, elaborate more

High or low Blood pressure

Yes

if Yes, elaborate more

if Yes. elaborate more

if Yes, elaborate more

Loss of skin sensation

Yes

if Yes, elaborate more

if Yes, Elaborate more

if Yes, elaborate more

Medical Odema

Yes

if Yes, elaborate more

Recent scars or surgeries (under 6 months)

Yes

if yes, elaborate more

Skin disorders

Yes

if Yes, elaborate more

During chemotherapy or radiotherapy

Yes

if Yes, elaborate more

I agree with terms and conditions and that the information I gave is true

Doctors note the requirement if medical condition or need adaptation to your treatment or upload proof of parking

Upload your file

Choose a file or drag and drop one here.

I agree to inform immediately, if my body temperature is getting higher than 37 °C, develop a chough or loose my sense of taste and smell in the last 2 hrs prior the treatment

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.