Appointment WHAT ARE YOU WAITING FOR… Make an appointmentLorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo. Step 1 of 2 50% Name(Required) Full Name Phone(Required)Email(Required) Address(Required) Street Address City State / Province / Region ZIP / Postal Code Treatment DetailsDate of treatment(Required) MM slash DD slash YYYY Time(Required) Hours : Minutes AM PM AM/PM Waxing(Required) Bikini Ear Half Arm Neck Underarm Boyzillian Eyebrow Half Leg Bottom Nipples Upper Lip Brazillian Fingers Half Leg Top Nose Buttocks Forehead Inner Thigh Shoulders Chest Full Arm Lower Back Sideburns Chin Full Back Lower Lip Stomach Crack Full Leg Navel Toes 808S OPT(Required) Bikini Half Arm Neck Underarm Boyzillian Eyebrow Half Leg Bottom Nipples Upper Lip Brazillian Fingers Half Leg Top Nose Buttocks Forehead Inner Thigh Shoulders Chest Full Arm Lower Back Sideburns Chin Full Back Lower Lip Stomach Crack Full Leg Navel Toes V-Juvenate XHave you had any similar treatment before?(Required) Yes No Please specify if you had any side effects post-treatment Please provide all conditions which you are currently receiving treatment Medical HistoryAre you consuming or applying any of the following Accutance Aspirin AHA or Glycolic Acid Vitamin B Retin A None of the above Others If consuming or applying any others, please specify Please provide any known medical conditions or allergies Shaving Adhesive Powder Body oil None of the above Others Others medical conditions or allergies, please specify Are you experiencing sunburnt / suntan? Yes No How long experiencing sunburnt / suntan (months) Medical History (Female customers only)Are you pregnant? Yes No It is NOT RECOMMENDED to do Brazillian treatment during the first trimester of pregnancy.How many months pregnant? if you have just given birth in the last 12 months, it is NOT RECOMMENDED to do Brazillian treatment less than 3 months for Natural Birth and 6 months for Caesarean section Natural Birth Caesarean section Duration after given birth Are you breastfeeding Yes No How many months breastfeeding? Consent(Required) l am signing this consent form as the parent/guardian of the person (who is under the age of 18) enjoying the treatment and I hereby declare and confirm that all information provided above (including his/her medical history) is true, correct and accurate. I further acknowledge and agree that all terms and conditions contained herein shall be legally binding on me.I hereby confirm that all information provided herein is true, correct and accurate to the best of my knowledge and further understand that any willful omission or dishonest disclosure shall render refusal of any subsequent treatment and provision of services by BEAU BORN BEAUTY. I shall not withhold any of the information necessary for or relevant to my desired treatment and shall promptly notify BEAU BORN BEAUTY of any changes to my condition (whether medical or otherwise) that may affect the appropriateness or suitability of my treatment with BEAU BORN BEAUTY By signing this form, I have acknowledged, read, understood and agreed to the terms and conditions contained herein (particularly on the pre and post procedure expectations, after-care instructions, all the benefits and risks associated to the treatment) and my acknowledgment and agreement shall be valid and effective throughout the procedure. I am aware that such terms and conditions are made available on BEAU BORN BEAUTY official website and hereby agree to adhere and abide to all the terms and conditions as may be set out by BEAU BORN BEAUTY.
