Tattooing/Microblading Consent Form

Tattooing/Microblading Consent Form

Please complete required details in full
PLEASE ONLY COMPLETE THIS FORM IF YOU HAVE ALREADY BOOKED A PATCH TEST. To book you can call or text 07960566422 or use the chat section on my website ***Patch testing a minimum of 48hrs before your appointment and is mandatory, your appointment CAN NOT go ahead without one***. Please do not ask for an appointment without first having a patch test, this is a legal requirement for insurance purposes and to keep you safe against having a major reaction. Please complete all details in full
Date of arranged patch test

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Personal Details

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Name*

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Area CodePhone Number
Date of birth*
Address*

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Statement

Please read these statements carefully
- Semi-permanent makeup is a form of tattooing.
- Re touch procedures will be required.
- A healing process of 6-8 weeks is required before a re touch procedure can be performed.
- On rare occasions the pigment may migrate under the skin.
- Application of semi-permanent cosmetics can be uncomfortable.
- The pigment will fade.
- Immediately after the procedure the pigment can be 30-50% darker than the required result.
- There may be immediate or delayed allergic reactions to pigment. However, allergic reactions are rare.
- A negative allergy test result will not guarantee that you will not have an allergic reaction.
- Allergic reactions to anaesthetics can occur.
- Semi-permanent cosmetics CAN NOT be applied to pregnant or nursing mothers.
- Semi-permanent cosmetics CAN NOT be applied to persons under the age of 18.
- Infections can occur if aftercare instructions are not followed correctly.
- There may be redness and swelling following the procedure.
- You may experience minor bleeding.
- If you have an MRI scan within 3 months of your cosmetic procedure we recommend that you discuss this with your doctor.
- Possible scaring, inconsistency of colour and loss of colour may occur.
1. I (your name)blanks* hereby authorize Jayne Webb of Lash Perfection, to perform upon myself the procedure of semi-permanent eyebrows(microblading/powder brows). If any unforeseen condition arises in the course of the procedure(s), calling in her judgment in to addition to, or different from those contemplated, I further request and authorize her to do whatever she seems advisable and necessary in the circumstances.
- I accept responsibility for determining the colour, shape and position of the semi-permanent cosmetic procedure as agreed during the course of the treatment.
- I fully understand and accept that non-toxic pigments are used during the procedure and that the cosmetic enhancement achieved will fade over a period of 6 months -3 years. Even though the colour will fade the pigment will stay in the skin indefinitely.
- I have been informed that the highest standards of hygiene are met and that sterile disposable needles and pigment containers are used for each individual client, procedure and visit.
- I understand and accept that each procedure is a process of requiring multiple applications odd pigment to achieve a desirable result, and that 100% success can not be guaranteed during the first procedure. I understand that this is why i need to return for a re-touch procedure.
- I understand that a re-touch procedure should be done after 30 days but within 3 months after the original procedure at the re-touch price. After this time it will be charged at the full price. I understand that it is my own responsibility to book the re-touch appointment.
- The results of the procedure are determined by the following factors:
- Medication
- Skin characteristics - e.g. dry, oily, sun damaged skin and thickness) Natural undertones(blending with chosen pigments)
- Personal PH balance of the skin, which can change visit to visit.
- Alcohol intake and smoking.
- Post procedure care
- Upon completion of the procedure there may be some swelling and redness of the skin, which will subside within 1-4 days. In some cases , bruising may occur. You my resume normal activities immediately following the procedure, however, using cosmetics, excessive perspiration and exposure to the sun of the effected area should be avoided. See specific post-procedure instructions for details. You can however, be assured that the procedure, even after only one treatment, looks acceptable so that you should feel comfortable appearing in public without additional makeup on the affected area.
- I have been advised that the true colour will normally be seen 4-8 weeks after each procedure, and that the pigment may vary in colour according to skin undertones, skin type, age and any skin conditions. I understand that some skins accept pigment more readily than others and there can be no guarantee given to the exact result of the effect or colour.
- To my knowledge I do not have any physical, mental or medical impairment or disability that might affect my well-being as a direct or indirect result of my decision to have the procedure done at this time.
- I am over the age of 18
- i am NOT pregnant or breastfeeding
- I am NOT under the influence of drugs or alcohol
- I agree to the follow all the pre-procedure and post-procedure instructions as provided and explained to me by the technician. Copies of after care advice will either be provided to me after my procedure or accessed via the website of lashperfection.info under aftercare
- Being of sound mind and body, I hereby release Lash Perfection of any and all responsibility. I accept any and all responsibility that might stem from my decision to have any semi-permanent cosmetic procedure performed by Jayne Webb at Lash Perfection.
- For the purpose of the documentation I also consent to the taking of before and after pictures of said procedures for record purposes and for the use in presentation portfolios, and for my details to be held on file and they will not be used for any marketing purposes.

We hold your appointments just for you and ask that if you must cancel or reschedule any appointment please provide us with at least 24-hour notice. This way, we will be able to adjust our schedules accordingly and we may be able to accommodate other clients on our waiting list. We do, of course, understand that unavoidable issues come up and will do our best to work with you in case of an emergency. Last minute cancellations or ‘no shows’ will be charged a cancellation fee each time. Here is our general breakdown of cancellation fees: • Less than 24-hour notice will result in a charge equal to 50% of reserved appointment(s) • NO SHOWS’ will be charged 100% of service amount Please understand that it is your responsibility to remember your appointment dates and times in order to avoid missed appointments and cancellation fees. You are always welcome to call and double check any appointments if you’re unsure.

I agree to the above statement

I hereby certify that I have read and fully understand all of the above consent and procedure permit; that the explained therein referred to were made and I accept full responsibility for these and/or other complications which may arise or result during or following the semi-permanent cosmetic/tattoo procedure which is to be performed at my request according to this consent and procedure limit. I confirm that all of the enclosed information provided by me for this consent form is correct to the best of my knowledge. I am over the age of consent (as explained to me) and i am not under the influence of any drugs or alcohol

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Tattooing/Microblading Consent Form

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