Microblading booking form

Microblading booking form
MICROBLADING IS NOT RECOMMENDED FOR ANYONE WHO IS OR HAS THE FOLLOWING:
- Sick with cold, flu, or sinus/respiratory infection (please reschedule your appointment and stay home to recover)
- Skin irritations including: sunburn, rash, eczema, shingles, acne, or psoriasis near the treated area
- Pregnant or nursing
- Under age 18
- Had Botox within 3 weeks from scheduled appointment
- Used Accutane in the past year
- Diabetes
- Epilepsy
- Undergoing chemo
- Prone to keloid scarring
- Pacemaker or major heart problems
- Had an organ transplant
- Viral infections and or diseases
- Transmittable blood disease, HIV or Hepatitis
I am not any ot them on the listI am on the list

Name*

First NameLast Name
Email*
example@example.com
phone number*
Please enter a valid phone number.

First time microblading*

YesNo
If NO, when, where have you done ?
service*

MicrobladingMicroblading + shadingDeciding
skin type*

OilyDry
health condition*

GoodSeen a doctor
Reason you see a doctor*
If no, write No
Taking medicine*

NoYes
Reason for taking medicine*
If no, write No
If yes, write medicine name *
If no, write No
Using anti-aging serum such as retinol, acid etc*

YesNo
Allergies*

NOYes
Allergy (ex, metallic, silver etc) *
If no, write No
Request Patch Test $50 (check 5-7 days 経過見)*

YesNo
How did you know about me? *
Instagram , google search , referred, yelp, etc
Close up front view of both brows without make up includes eyes *

check balance of brows
Cancelof
front view of both brows with your usual make up includes eyes*

chekck for usual your make up brows
Cancelof
REQUIREMENTS BEFORE EYEBROW MICROBLADING:
1. No Botox treatments should be done 3 weeks prior or 4 weeks after procedure
2. No chemical peels 60 days before or after procedure (brows will peel quicker due to chemicals traveling under the skin)
3. No Retinols/Retin-A or other anti-aging/acne creams, or serums containing acids as these will fade brows prematurely
4. Do not work out or sweat heavily the day of the procedure (or 2 weeks after)
5. Do not tan or have a sunburned face the day of the procedure
6. No waxing or tinting 3 days before procedure
7. Stop taking aspirin, niacin, vitamin E, fish oil, CoQ10 and ibuprofen 48 hours before procedure
8. No alcohol or caffeine 24 hrs before procedure
Things to avoid after microblading for 7 days
- Do not put water, soap, skincare on your brows.( recommend whole face)
- No picking, scratching, touching brows.
- NO direct sun-tanning.
- Kepp putting wacelinn 7 days
- keep cleaning 14 days
MEDICATIONS TO AVOID BEFORE MICROBLADING
The following medications are known to affect the blood clotting process. Therefore, these medications need to be avoided (7) seven days prior to your procedure.
- Actron, Advil, Aggrenox, Aleve, Alka-Seltzer Anacin, Anaprox, Anexsia w/Code, Anodynos, Ansaid A.P.C. Artrotec A.S.A. Ascriptin Aspergum Aspirin Axotal
- B-A-C Bayer Bexophene Bextra Brilinta Buffered Aspirin Buffaprin Bufferin Buffinol
- Cama Arthritis Strength Cataflam Celebrex Cheracol Capsules Clinoril Clopidogrel Combunox Congespirin
- Damason-P Darvon Dasin Daypro DHC plus Dia-Gesic Diclofenac Dipryridamole Disalcid Dolabid Dolprin #3 Doxaphene Dristan
- Easprin Ecotrin Emagrin Forte Empirin Equagesic Equazine Etodolac Excedrin
- Feldene Fenoprofen Fiogesic Fiorgen PF Fiorinal 4-Way Cold Tablets
- Ginko Biloba Gemnisyn
- Ibuprofen Indocin Indomethacin
- Ketoprofen Ketorolac
- Liquprin Lodine Lortab
- Magnaprin Marnal Measurin Meclofenamate Mefenamic Meloxicam Meprobamate Midol Mobic Momentum Motrin
- Nabumetone Naprelan Naprapac Naprosyn Naproxen Norgesic Nuprin
- Orudis Oruvail Oxaprozin
- Pabalate P-A-C Percodan Persantine Persistin Piroxican Plavix Pletal Ponstel Prevacid w/ Naprapac Presalin Profen
- Relafen Robaxisal Roxiprin Rufen
- Salsalate Saleto Salocol Soma Compound Sprix Nasal Spray St. Joseph Sulindac Supac Synalgos-DC
- Talwin Ticagrelor Ticlopidine Ticlid Tolectin Tolmetin Toradol Trental Trigesic Trilisate
- Ultraprin Uni-Pro
- Vanguish Vicoprofen Vimovo Vitamin E Voltaren
- Zipsor Zorpin
booking date*

anytimeafter 2 weeks (because need to stop serum ..etc)
Request for the booking date, time *
.
Location*

Las Vegas, NVSunnyvale, CA
Message
quesions , notes,
Accept Cash. 現金. I will check and contact you shortly! Thank you!
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