• Meadowlark PMU Studio

    Client Intake Form
  • This form is designed to give information needed to make an informed choice of whether or not to undergo a permanent makeup (PMU) application. If you have questions, please don't hesitate to ask.

    Although PMU 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 dermal layer of the skin and is a form of tattooing.

    All instruments that enter the skin or come into contact with bodily 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 to expect a touch up after the healing is completed.
    Initially the color will appear more vibrant and darker compared to the end result. Usually within 5-7 days, the color will fade 40-50%, soften and look more natural. The pigment is semi-permanent and will fade over time and will likely need to be touched up within 6-18 months.
    **Please note that color may fade faster on oily skin**

     

  • • The nature and method of the proposed cosmetic tattoo procedure(s) has been explained to me by my technician and/or all artists working at the Meadowlark studio including the usual risks inherent in the procedure process, and the possibility of complications during and following the procedure(s). I understand there may be a certain amount of discomfort or pain associated with the procedure(s) and that other adverse side effects may include minor and temporary bleeding, bruising, swelling, and/or redness or other discolorations. Fading or loss of pigment may occur. Unevenness in the design may occur due to swelling. Secondary infection in the area of the procedure may occur, however, if all after care instructions (that are provided) are followed, is rare.

    • I have informed my artist at the Meadowlark studio of any and all health problems.

    • I acknowledge that complications including infection are always possible as a result of cosmetic tattoo procedure(s), particularly in the event my post-procedural instructions are not followed.

    • I acknowledge that it is not reasonably possible to determine whether I might have an allergic reaction to any of the pigments, dyes, topical preparations, or processes used in the procedure; and I agree to accept the risks that such a reaction (although rare) is possible. I have informed my artist at Meadowlark studio of any existing problems.

    •It has been explained to me that immediately after the procedure(s) is completed, the color will appear dark and the design will appear to be thicker. It has also been explained to me that within a short period of time (usually 5-7 days) during the healing process, the color will lighten/soften and the design will heal thinner than it looked the day it was performed.

    • I acknowledge that hyper-pigmentation (darkening of skin) or hypo-pigmentation (absence of color in the skin), or scarring is a possibility as a result of my body’s reaction to the skin being broken during the procedure. I realize my body is unique and that my artist and the Meadowlark studio cannot predict how my body will react as a result of this procedure.

    • I acknowledge that the procedure(s) will result in a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove the results. Tattoo removal is a surgical procedure which may cause scarring or disfigurement.

    • I understand that future laser treatments, plastic surgery, implants, injections, and other skin altering procedures may alter and degrade my cosmetic tattoo procedure(s). I further understand that such changes are NOT the responsibility of my artist at the Meadowlark studio, and such changes may NOT be correctable through further cosmetic tattoo procedure(s).

    • I understand that tattoos may cause MRI (Magnetic Response Imaging) artifacts and that there is a 1-2% chance of a reaction. Within that 1-2% for almost all there will be a warming and/or tingling sensation in the tattooed area from the MRI due to the iron oxide properties of some pigments. It is understood that I should advise my physician that I do have permanent cosmetics (a tattoo) in the event an MRI procedure is prescribed.

    •I acknowledge the receipt of written instructions advising me of the proper care of my procedure(s), and ointment by my artist at the Meadowlark studio. I understand the absolute necessity for following these instructions.

    •I understand that cosmetic tattooing is an art form and NOT an exact science, and I acknowledge that NO guarantees have been made to me as to the result of this procedure. Some skin types will not accept or heal pigment in a consistent manner. Your skin and how well you take care of your procedure(s) will determine your result. I realize my body and myskin is unique and that my artist and the Meadowlark studio cannot in any way predict how your skin may react to the procedure or how it may or may not accept color. I also realize that my artist at the Meadowlark studio cannot predict how many visits it will take to complete my procedure.

    • The fee for the cosmetic tattoo procedure(s) have been explained to me, including the initial procedure fee, touchups fees, and maintenance fees. These fees are understood and agreed upon. I understand the total fee for services rendered is due upon the completion of the initial procedure and that there will be separate fees for touch up/follow up work.

    • I understand that the Meadowlark studio does NOT include a free touchup appointment(s) in the initial procedure price. All touch up/follow up appointments ARE a separate fee. A “follow up” appointment is often needed to complete, adjust, or fine tune the initial procedure or maintenance procedure. All follow up appointments will be charged a fee of $50.00 and must be scheduled within 3 months of the initial procedure. After 3 months, the follow up will increase accordingly and such pricing can be found on the studio’s website. An 8.1% sales tax is added to the service pricing.

    • I accept full responsibility for determining the color, shape, and position of the pigments that will be applied. I understand the actual healed color of the pigments will be modified slightly due to my own unique skin undertones.

    • Due to the fact that your approval is obtained prior to final selection of color to be implanted and design application(s), that all the facts about cosmetic tattooing have either been disclosed or discussed with you, and that you have been given full opportunity to have any and all questions answered, my artist and the Meadowlark studio employs a no refund policy.

    • Any artist of the Meadowlark studio has the right to refuse service to anyone at any time for any reason.

    • This contract is to remain in effect for as long as I remain a client of the Meadowlark studio and all of its contents apply whenever work is performed on myself by any artist of the Meadowlark studio. It is my responsibility to inform my artist at Meadowlark studio if any changes have occurred in my medical history.

    •I have read and understand the contents of each paragraph above. I have received no unrealistic warranties, or guarantees from my artist or the Meadowlark studio with respect to the benefits to be realized from, or the consequences of the aforementioned procedure(s).

    • I acknowledge by checking off on this consent form, I have been given the full opportunity to ask any and all questions about cosmetic tattooing procedure(s), it’s process, and the risks involved from my artist and the Meadowlark studio. The decision to have cosmetic tattooing procedure(s) performed is my own and I understand and accept all risks involved, therefore releasing my artist and the Meadowlark studio of any and all legal liability. My artist and the Meadowlark studio are exactly that, an artist, a highly trained and skilled artist and make no claims to be anything more. Permanent makeup/cosmetic tattooing is not medical procedure but an art form, the art of tattooing. No refunds... no exceptions.

  • • There can be pain even after the topical anesthetic has been used. Anesthetics work better on some people than others.

    • Infection is very unusual. The areas treated must be kept clean and only
    freshly cleaned hands should touch the areas. See the 'Aftercare' sheet provided to you for instructions on how to care for your new brows.

    • Asymmetry can result from poor healing, infection, bleeding, or many
    other causes. Your follow up appointment will likely correct any uneven appearance.

    • Every effort will be made to avoid asymmetry, but our faces are not
    symmetrical, and so adjustments may be needed during the follow up appointment to correct any unevenness.

    • Some people bruise and swell more than others. Ice packs may help the bruising and swelling typically disappears within 1-5 days. Some people don't bruise or swell at all.

    • Topical anesthetics are used to numb the area to be tattooed. Lidocaine,
    Prilocaine, Benzocaine, Tetracaine, and Epinephrine in a liquid, gel, or cream form are
    typically used. If you are allergic to any of these, please inform me beforehand! Feel free to call or text (406)672-3211

    • Because pigments used in permanent cosmetic procedures contain iron oxides, a
    low level magnet may be required if you need to be scanned by an MRI machine. You
    must inform your technician of any tattoos or permanent cosmetics.

    • There is a small possibility of an allergic reaction. You may take a
    5-7 day patch test to determine this before going forward with the procedure. If you want to take a patch test before scheduling for a procedure, please call or text to set that up, at (406)672-3211.

    • I acknowledge that aftercare instructions will be explained to me and a written copy provided to retain in my possession, which I will follow to the best of my ability. If I have questions, I will call or email you.
    • I understand that a certain amount of discomfort is associated with this procedure and that swelling, redness, light bleeding and bruising may occur.
    • I understand that Retin-A, Renova, Alpha Hydroxy, and Glycolic Acids must not be used on the treated areas, and that they will alter the color.
    • I understand that sun, tanning beds, pools, some skincare products, and medications may affect my permanent makeup.
    • I will tell all skincare professionals or medical personnel about my permanent makeup procedures, especially if I am scheduled for an MRI.
    • I accept the responsibility for my explanation to you of my desire for specific colors, shape, and position for any procedure done today.
    • I understand that implanted pigment color can slightly change or fade over time due to circumstances beyond your control and that I may need to maintain the color with future applications and a touchup session within 3 months.
    • I acknowledge that the proposed procedure(s) involve risks inherent in the procedure and have the possibilities of complications during and/or following the procedures such as: infection, misplaced pigment, poor color retention, and hyper-pigmentation.
    • I have been quoted the cost of today's appointment while scheduling this appointment. There will be no refunds for this/these elective procedure(s)
  • Should be Empty: