Permanent Make Up Information Forms Logo
  • Permanent Make Up Information Forms

    Amber Nicole & Co.
  • This form is designed to give information needed to make an informed choice of whether or not to undergo a 3D Eyebrow, Microblading/ Ombre Powder/Combo, semi-permanent makeup application. If you have any questions, please don’t hesitate to ask.

     Although 3D Eyebrow Permanent Make Application in the form of Microblading or Microshading (Ombre Powder) 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.

     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 will appear more vibrant or 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. Additional touch-ups are likely needed within 6 months to 2 years

  •  - -
  •  -
  • Pre-Procedure Questionnaire

  • Acknowledgment and Waiver

  •  - -
  • Powered by Jotform SignClear
  • Photography and Video Release Form

    Pictures helped you make your decision, help someone else
  • I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video without payment or any other consideration.

    I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears.

    Additionally, I waive the right to any loyalties or other compensations arising or related to the use of my image or recording.

    I also understand that this material may be used for in diverse educational settings within an unrestricted geographic area.

    Photographic, audio, or video recordings may be used for the following purposes:

    ·       Social Media Advertising

    ·       Business Advertising

    ·       Online Portfolio

    ·       Conference presentations

    ·       Educational presentations or courses

    ·       Informational presentations

    ·       Online Educational videos

    By Signing this release, I understand this permission signifies that photographic or video recordings of may be electronically displayed via the Internet or in the public educational setting.

     I will be consulted about the use of the photograph or video recording for any purpose other than those listed above.

     There is no time limit on the validity of this release nor is there any geographic limitation on where some of the material may be distributed.

    This release applies to photographic, video, or audio recordings collected as part of the sessions listed in this document only.

    By signing this form, I acknowledge that I have completely read and fully understand the above release form. I agree to be bound thereby, I hereby release any and all claims against any person or organizations utilizing this material for educational and/or advertising purposes.

  •  - -
  • Powered by Jotform SignClear
  • Possible Risks, Hazards, or Complications

  •  - -
  • Powered by Jotform SignClear
  • Should be Empty: