• BOMB BROWS Permanent Makeup Client Information Form

  • This form is designed to give information needed to make an informed choice of whether or not to undergo microblading, Ombre, lip blush, eye lash enhancement, eyeliner, saline removal, or Semi-Permanent Makeup application. It is the client's responsibility to research these services & conduct their due diligence before receiving permanent cosmetics. If you have any questions please don't hesitate to ask.

    Although Eyebrow Microblading and Semi-Permanent Makeup application is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure.

    This is the process of inserting pigment into the basal layer of the epidermis. It is a form of tattooing, though semi-permanent, can have long lasting results.

    All instruments that enter the skin or come in contact with body fluids are disposable and disposed of after use. Cross contamination guidelines are strictly adhered to.

    Generally the results are excellent. However, a perfect result is not a realistic expectation. It is usual and advised to expect a touch up after healing is completed.

    Initially the color the will appear more vibrant or darker compared to the end result. Within 5-7 days the color will fade 40-50%, soften, and look more natural. The pigments semi-permanent and will fade over time. Additional touch ups required 8-12 weeks post initial services, and also color boost 1-3 years following or as needed. Aftercare instructions and expectations are provided to each client via email and text.

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  • Driver's License Photo

    A photo of your valid driver's license is required.
  • Photo Release- I acknowledge that my photos will be taken before, during, and after services for both insurance liability and advertising needs of Bomb Brows LLC. 

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  • Please answer the following question with full honesty and accuracy.
  • Please read all the sentences and sign the agreement. I authorized BOMB BROWS LLC to perform a cosmetic enhancement service. I was informed that permanent and semi-permanent cosmetic enhancement is the same as the process of tattoo and it is an advanced version of it. I completely understand that in some rare cases, allergic reactions may occur even after my disclosure of all known allergy history I may have due to the pigment. I accept all the responsibility, and I fully understand the health risk of it. I accept that the pigment might fade before or after 3 years, and may leave a mark or residue of color. I understand the possible side effects of the procedure and will be able to diagnose if it is normal or not. I confirm that I do not have any physical, medical, and mental conditions that might get conflict with the procedure. I confirm that I will strictly follow the pre and post-procedure instructions given to me. I confirm that all information I entered in this form is accurate and true to the best of my knowledge. I hereby certify and give this clinic my full consent to perform the necessary procedure. By signing below, I confirm that I have read and understood the statements above.

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  • Client Medical History

  • EMERGENCY CONTACT INFORMATION - PLEASE LIST YOUR EMERGENCY CONTACT BELOW

  • CLIENT MEDICAL HISTORY FORM

    DO YOU CURRENTLY/ HAVE YOU EVER HAD:

  • POSSIBLE RISKS, HAZARDS, or COMPLICATIONS
    PAIN: There can be pain even after the topical anesthetic has been used. Anesthetics work better on some people than on others.
    INFECTION: Infection is very unusual. The areas treated must be kept clean and only freshly cleaned hands should touch the area. See "after care" sheet for instructions on at home care.
    UNEVEN PIGMENTATION: This can result from poor healing, infection, bleeding, or many other causes. Your follow-up appointment will likely correct any uneven appearance.
    ASYMMETRY: Every effort will be made to avoid asymmetry, but our faces are not symmetrical so adjustments may be needed during the follow up session to current any unevenness.
    EXCESSIVE SWELLING or BRUISING: Some people bruise or swell more than others. Ice packs may help reduce the swelling. The swelling or bruising typically disappears in 1-5 days. Some people don't bruise or swell at all.
    ANESTHETICS: Topical anesthetics are used to numb the area to be tattooed. lidocaine, Prilocaine, Benzocaine, Tetracaine, and/or Epinephrine cream and/or liquid are used. If you are allergic to any of these, please inform me now.
    MRI: Because pigments used in Permanent Cosmetic procedures contain inert oxides, a low level magnet may be required if you need to be scanned by an MRI machine. You must inform your MRI Technician of any tattoos or permanent cosmetics.


    I understand that upon submitting this form, I will AUTOMATICALLY be chared a deposit fee of $75 PER SERVICE using the credit card on file. That booking fee must be paid prior to my appointment being confirmed. This booking fee will go towards the price of my service. Failure to pay it will result in my appointment being declined. I understand this booking fee is non-refundable but can be transferable as needed- or with proper notice of at least 72 hours. I understand all sales are final and NO REFUNDS will be given.  

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    Notice* It is generally reccomended all clients consultant with their Doctor prior to recieveing any permanent or semi-permanent cosmetic services.

  • Credit Card Authorization

    I authorized Bomb Brows LLC to charge my credit card or debit card on file for deposits, late or cancellation fees, no show fees and service fees up to the full cost of service.
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