• Laser Tattoo/Pigment Removal Consent Form

    Please ensure you have completed the Consent Form at least 48 hours prior to your treatment appointment. Failure to do so may result in your appointment being postponed and the loss of your deposit. If you have any questions or concerns please contact us on 07418 610856 or info@justbrowsinc.com

  • Personal Information

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Treatment Details

  • Which treatment are you having?*
  • Have you used any of the following in the past 30 days?*
  • Gender*

  • Medical Information

  • Please select any of the following if applicable:*
  • Have you ever used, or are you currently using, Retin-A, retinoids or glycolic acid?*
  • Are you currently taking, or have you recently taken, isotretinoin/Roaccutane? If yes, please provide the dates and details below.*
  • Do you have any implants?*
  • Do you have a pacemaker, implanted defibrillator, cochlear implant, insulin pump, or any metal plate, screw or other implant in or near the proposed treatment area?*
  • Do you have any skin sensitivities or allergies?*
  • Have you had any major surgery performed in the last 3 months?*

  • Informed Consent and Risks

  • I authorise Sarah Jane Sivyer of Just Brows Inc. Ltd to perform the laser treatment selected above using the AW3® laser system.

    I understand that reduction, removal or improvement may be incomplete, that multiple sessions may be required, and that the number of sessions and final result cannot be guaranteed. I understand that alternative treatment options, including having no treatment, are available.

    I understand that recognised risks include:

    • Post-treatment discomfort, redness, swelling and tenderness.

    • Blistering, burns, crusting, scabbing or pinpoint bleeding.

    • Infection.

    • Scarring or changes in skin texture.

    • Temporary or, rarely, persistent hypopigmentation or hyperpigmentation.

    • Incomplete or uneven pigment clearance.

    • Colour change or paradoxical darkening, particularly in cosmetic or permanent makeup pigments.

    • Allergic or inflammatory reactions following pigment fragmentation.

    • Hair lightening or temporary hair loss in the treated area.

    • The need for multiple sessions, with no guaranteed number of sessions or outcome.

  • Client Understanding

  • Do any of the following apply to you? Please tick those that apply:*
  • Please check every statement to confirm your understanding:*

  • I agree to follow all pre-treatment and aftercare recommendations. I understand that excessive heat should be avoided for 48 hours and that sun exposure, including sunbeds, must be avoided for 30 days before and 30 days after treatment. Sunscreen with SPF 30 or higher must be used on exposed treated areas. Failure to follow this guidance may increase the risk of complications or less-than-optimal results.

    I agree to contact Just Brows Inc. Ltd promptly if I experience any unexpected or concerning adverse effects.

    I understand that results vary between individuals and that payment is for the treatment provided, not a guaranteed outcome. Refunds will not be provided solely because the desired degree of clearance or improvement is not achieved, subject to my statutory rights.

    I understand and accept the recognised risks and limitations of the treatment. Nothing in this consent form affects my statutory rights or excludes liability where it cannot lawfully be excluded.

    I confirm that I have read and understood this consent form, have had the opportunity to ask questions, and all my questions have been answered to my satisfaction.

  • Photography & Video Release Consent

    I understand that before-and-after photographs are required for my confidential treatment and insurance records.
  • I give permission for my photographs or videos to be used for marketing, social media, website and educational purposes.*
  • Date*
     / /
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: