NufreeFinipil Client Release Form

Nufree finipil hair removal should not be combined with any other products. Your technician will only be using Nufree approved epilating strips, applicators, erasing lotion if necessary, and finipil antiseptic. No alcohols, astringents or powders can be applied before removal. After the removal is complete, finipil antiseptic will be applied to instantly cool and protect the now empty follicle.

  1. Are you using Retin A (trentoin) or any of the following: (Adapalene, Isotretinoin, Clindamycin/tretinoin, Tazarotene, Acitretin, Bexarotene, Alitretinoin, Fluocinolone/Hydroquinone/Tretinoin)? ______
  2. Are you taking Accutane? ______(If yes your technician will not be able to perform any hair removal.)
  3. Are you currently undergoing any Chemical Peels, Dermabrasion, Facial Surgery, or Laser Treatment? ______(If yes you need to have a doctor’s release that there has been enough time since treatment in order to service the area affected.
  4. Are you using any over the counter products that contain Glycolic acids, Alpha hydroxyl acids, Benzoic acids, Benzoyl Peroxide, or Salicylic acids for wrinkles or blemishes? ____ (If yes you must be free of these products 72 hours on the area to have hair removal.)
  5. Are you under a physician’s or dermatologist’s care? _____ if yes for what medical conditions? ______
  6. Are you taking any medications that can cause thinning of skin such as (blood thinners and corticosteroids)? ______(If yes your technician will do a patch test to determine whether or not you can have the service and/or consult your prescribing physician.)
  7. Are you taking any medication that may cause water retention? ______(Some hormone drugs containing estrogen, blood pressure lowering medications, antidepressants and steroids may cause water retention.)
  8. Are you pregnant? ______Are you expecting or in a menstrual cycle? ______

Water retention can cause temporary puffiness or reddening, especially on the facial/sinus areas. Your technician will take a precautionary thumb print test to see if this may occur, and if he/she feels it may, they will apply a cold wet compress over the finipil antiseptic after hair removal for 60 seconds.

In order for your technician to perform an efficient hair removal you must have at least 7 to 10 days hair growth for your 1st Appt._____ 2nd Appt. (Minimum 3 to 4 weeks from 1st)______

Client Name:______Address: ______

______Phone:______

I confirm to the best of my knowledge that the answers I have given are correct and I have not withheld any information.

Signature:______Date:______