• I hereby authorise Hannah Louise Foster of Hannah Louise Beauty, practicing at True You Skin Clinics, to perform upon myself the Microblading treatment.
• If any unforeseen condition arises in the course of this procedure, calling in her judgement in addition to, or different from those now contemplated, I further request and authorise her to do whatever she deems advisable and necessary in the circumstances.
• l accept responsibility for determining the colour, shape and position of the permanent cosmetic procedure as agreed during the course of my consultation.
• I understand that an allergy test does not guarantee that I will not have an allergic reaction to the pigment.
• Hannah cannot accept responsibility if the treatment area does not effectively numb. Each individual is different according to skin type. For all procedures a cream or gel topical anaesthetic is used. These products are perfectly safe, and can be purchased over the counter from any chemist.
• I fully understand and accept that non-toxic pigments are used during the procedure and that the cosmetic enhancement achieved may fade over a period of 1-3 years. Even though the colour has faded the pigment will stay in the skin indefinitely.
• l 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 requiring multiple applications of pigment to achieve desirable results, and that 100% success cannot be guaranteed during the first procedure. I understand that this is why I will need to return for a retouch procedure.
• I understand that a retouch procedure will be performed 6 – 12 weeks after the initial procedure and that after a 12 week period I will be charged an additional fee for any further work. I understand that it is my responsibility to book
the appointment at a time convenient for both parties.
• The result of the procedure is determined by the following: medication, skin characteristics (dry, oily, sun-damaged and thickness), natural skin undertones - (blending with chosen pigment), personal pH balance of skin, which changes from visit to visit, alcohol intake, smoking, and adhering to Post Procedure care treatment.
• Upon completion of the procedure there may be swelling and redness of the skin, which will subside between 1-4 days. In some cases, bruising may occur. I understand I can resume normal activities immediately following the procedure however, using cosmetics, excessive perspiration, steamy showers and exposure of the sun to the affected area should be avoided.
• l have been advised that the true colour will be seen 4 weeks after each procedure and that the pigment may vary in colour dependent on skin tones, type, age and conditions. I understand that some skins accept pigment more readily than others and no guarantee to an exact effect or colour can be given.
• l agree to follow all pre-procedure and post-procedure instructions as provided and explained to me by Hannah. I confirm that I have received copies of all the relevant aftercare instructions.
• Being of sound mind and body, I hereby release any and all responsibility. I accept any and all responsibility myself for any consequence that might arise from my decision to have any permanent cosmetics procedure performed by Hannah.
• For the purpose of documentation, I also consent to the taking of "before and after" photographs of said procedure(s) for record purposes and for use in presentation portfolios.
I CERTIFY THAT I HAVE READ AND HAVE HAD EXPLAINED TO ME AND FULLY UNDERSTAND THE ABOVE CONSENT AND PROCEDURE PERMIT; THAT THE EXPLANATIONS 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 COSMETIC PROCEDURES WHICH IS TO BE PERFORMED AT MY REQUEST ACCORDING TO THIS CONSENT AND PROCEDURE PERMIT.
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. l am over 18 years of age. I am not pregnant. I am not under the influence of drugs or alcohol.