• Brow Lamination & Tint

    Consent Form
  •  -
  • Did you have a recent Microblading or Tattoo service?   *   
    If yes, how long ago?      

    Did you have a recent Brow Henna application?   *
    If yes, how long ago?      

    Did you recently receive a Botox or Dermal Filler?   *
    If yes, how long ago?      

    Are you on any anti-ance medications such as Roaccutane, doxycycline and Epiduo gel etc?       *
    If yes, please explain what you are taking:      

    Are you on any anti-ance creams Vitamin A, Retinols, AHA's and BHA's?   *
    If yes, please explain what you are taking:      

    Have you had Lash or brow tinting, lash lifting, lash perming, eyelash extension or semi-permanent mascara applied previously?    * 

  • Agreement

    I request and consent to these procedures being carried out today without undergoing a sensitivity patch test. The sensitivity test, which if conducted may indicate my sensitivity/allergy to the products. I under he contents of this form and take full responsiblity for my actions, thus absolving all other parties of their responsibilites, if any, associated with the supply of the products and services(s).

     

  • Clear
  •  -  -
    Pick a Date
  • Should be Empty: