Thank you for choosing Brow Design Studio.
You have selected to download the forms and fill them in manually. To do so scroll over the image below and click the download arrow in the top right corner .
You must complete the form NO LATER than 10 days before your appointment, if you complete the form inside of that and you find you need Doctors consent and or you can not have the treatment you may lose your deposit.
If you have ticked any of the contraindications you can not have the treatment at this time. If you have any other medical issues or unsure about anything else give the office a call on 01305 750302 or 07961 347882 or email email@example.com
You will now be directed through our online forms. Please complete them as soon as possible, so that if we need to take any medical conditions or medications into consideration you will have sufficient time to gain your Doctor's consent before your treatment if needed. The form will take around 20 minutes to complete.
If this is your first treatment, you wll receive 2 plasters in the post in the next few days. Please follow the instructions.
Paper copies of these forms can be dowloaded if you would prefer. If you choose to do this please advise us with plenty of notice if anything in the contraindications or Doctor's consent section has been ticked.
If you arrive at your appointment with a contra-indication or Doctors consent needed that you haven't advised us of prior to your appointment, we will not be able to proceed with your treatment and this will result in the loss of any deposit paid.
I understand that I have opted to download the form and complete in manually and I will notify my artist no later than 10 days before my appointment the results? I understand I must now submit this entry.
Applicable to brand new treatments only. If you are an existiing client who is having a colour boost, please sign below to confirm you have previously completed a patch test.
In the next few days you will receive an envelope containing 2 plasters. One containing pigment, and the other with numbing cream. Please follow these instructions and carry out your test ASAP so that we know we are fine to proceed with the treatment.
• Fold back the protective backing on one of the plasters to reveal the pigment.
• Re- hydrate the pigment by adding a drop of tap water to the centre of the plaster.
• Place the plaster on the top of your left thigh.
• Repeat this procedure for the second plaster in this case placing the plaster on your right thigh.
• After 24 hours remove the plaster and examine the skin. If there is no reaction, i.e. Redness, swelling, irritation or itching it is safe to proceed with your permanent cosmetic enhancement. Should you experience any of the symptoms mentioned above at any point, remove the plaster and immediately flush the area with cold water.
Please note that the correct colour will be mixed for you at your scheduled appointment. The colour is for sensitivity test purposes only.
On completion of your sensitivity test sign below and bring the completed document to your appointment.
Please note that if you haven’t already done so, a deposit of £50 is required for all treatments. Appointments will automatically cancel 7 days prior to treatment date if a deposit is not registered against the appointment. To pay your deposit please click the link that was emailed to you when you booked.
Please sign below to say that you will carry out the sensitivity test for pigment and numb cream as instructed before my appointment, and will advise if I have displayed any symptoms of sensitivity.
I understand that permanent cosmetic enhancement is an advanced form of tattooing.
I accept responsibility for determining the colour, shape and position of the enhancement as agreed during the course of my consultation.
I understand that a sensitivity test for pigment does not guarantee that I will not have an allergic response. I am aware of that allergic response to pigment is rare and accept all responsibility if allergic response occurs. I am aware that a sensitivity reaction to anaesthetics can occur and accept all responsibility if allergic response occurs
I fully understand and accept that non-toxic pigments are used during the procedure and that the cosmetic enhancement achieved may fade over the course of 1-3 years. Even though the colour has faded, the pigment will stay in the skin indefinitely and may leave a light residue of colour.
I accept that the highest standards of hygiene are met, and that sterile disposable needles are used for each individual client, procedure and visit and that each procedure is a process requiring multiple applications of pigment to achieve desirable results, and that 100% success cannot be guaranteed. I understand that this is why I need to return for a control procedure that is included in the initial price.
I understand that the control procedure (re-touch appointment) will be performed 1-3 months after the initial procedure and that after a 3-month period I will be charged an additional fee for any procedures. I understand that a control procedure takes place 4- 12 weeks after the initial application to allow the procedure site to fully heal. I will book the appointment when it is convenient for both parties.
I understand that permanent cosmetic enhancement is an invasive procedure and the infusion process can be uncomfortable and I also understand that the pigment may migrate under the skin, however this is a rare occurrence.
I understand that loss of any eyelashes during the healing of permanent cosmetic eyeliner enhancements will result in new eyelash growth over a 4 month period and that eyelash loss is rare and minimal and in rare cases that corneal abrasion can occur during eyeliner procedures.
I am aware that the result of the procedure is determined by the following:
• Skin Characteristics - i.e. dry/oily/sun-damaged
• Natural skin undertones
• Alcohol intake and smoking
• General stress
• A compromised immune system
• Poor diet
• Post procedure care treatment
I have been advised that upon completion of the procedure there may be swelling and redness of the skin, which will subside within 1-4 days dependent on lifestyle. In some cases bruising can occur. I have been advised that I can resume normal activities immediately following the procedure, however, using cosmetics, prolonged exposure to water, excessive perspiration and exposure to the sun should be limited for up to two weeks following the infusion process.
I understand that immediately after the procedure the enhancement can be 30 to 50% darker than the desired result and can take between 4-10 days to lighten. I understand that the true colour will be visible 1 month after each application, and that the colour may vary according to skin tones, skin type, age and skin conditions. I appreciate that some skins accept colour more readily than others and no guarantee of an exact effect or colour can be given.
I am aware that if I have had a previous outbreak of cold sores/herpes and receive a lip enhancement I may have an outbreak again following the procedure. I have been made aware that anti-herpes medication is available over the counter or on prescription and has been shown to prevent or minimize such outbreaks.
I am aware that that if I have had a previous eye disorder or eye infection and receive an eyelash enhancement, the disorder may reoccur again. I agree to use the correct medication to prevent such a disorder reoccurring.
I am aware that even though my vision is not affected by permanent cosmetic eye enhancements I may wish to have someone drive me home.
I understand that I may experience dry lips for up to two weeks following permanent cosmetic lip enhancement.
I understand that there are few effective methods for pigment removal. Laser removal has proven successful, however is a process.
I agree to inform my doctor of my permanent cosmetic enhancement if I require a MRI scan within a 3 month period of receiving the procedure.
I agree to dowload, read and follow all post-procedure instructions as provided and explained to me by the practitioner. I understand that infection and possible scarring can occur if I do not adhere to the said instructions.
I agree to download, read and follow all pre-treatment instructions at least 2 weeks before my treatment.
To my knowledge I do not have any physical, mental, or medical impairment or disability that might affect my wellbeing as a direct or indirect result of my decision to have the procedure done at this time. I am at least 18 years old. I am not under the influence of drugs or alcohol.
I understand it is my responsibility to book a retouch appointment that must be completed within 8 weeks of my original treatment. Contact 07961 347882 or email firstname.lastname@example.org
I understand that my retouch appointment is included in the price, however if I cancel my retouch appointment within 48 hours I will be charged £50.00 for a new appointment
For the purpose of documentation, I also consent to the taking of “before” and “after” photographs of said procedure(s) to be filed for reference only.
I CERTIFY THAT I HAVE READ, AND HAVE HAD EXPLAINED TO ME, AND FULLY UNDERSTAND THE ABOVE CONSENT FORM AND THAT I HAVE REQUSTED TO HAVE PERMANENT COSMETIC ENHANCEMENT OF MY OWN FREE WILL.
Please tick the boxes below and sign using your finger or mouse
If you have ticked a Contra-Indication Or are Pregnant or Breast Feeding you can not have the treatment at this time.
Contra-Indications, what are they, and how do they effect your treatment?
If you have ticked one of the contract-indications, this means that you can not have this treatment at this time. Some of these conditions may be temporary and you may be able to proceed with the treatment at a later date.
Please feal free to discuss conditions with us and we will advise accordingly.
If this is the case and you have paid a deposit you will be entitled to a refund providing you have notified us with a minimum of 48 hours notice.
If you ticked this section by mistake you will need to complete the form again, but please remember if you are unsure please contact the office on
Remember, contra-indications are there to protect you.
Our aim is to keep our environment as safe as possible for you, so we have put in place some new procedures inline with government guidelines.
Luckily, our environments are small and private spaces. In Weymouth, we have a capacity of 1 artist and 1 client.
In Poole, a maximum of 2 clients and 2 artists, both using their own private rooms. So in terms of set up, ours could not be more ideal.
This may all sound quite clinical. Unfortunately they are necessary precautions and are following government and industry guidelines.
Our promise to you is this as always: The greeting will be equally as warm, we are still the same people, and your treatment will in NO WAY be compromised.
If, when you submit it says "There are errors on the form. Please fix them before continuing." scroll back up and make sure the relevant boxes are ticked