Brow Lamination Client Consent Form

Brow Lamination Client Consent Form
Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
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How did you hear about us?

Client Consent

Although every precaution will be taken to ensure my safety and wellbeing before, during and after the brow lamination process, I am aware of the following information and possible risks:
I understand that during the treatment, despite all the precautionary measures, injury is possible. I will not hold the technician or business performing this services on me responsible in any way for any damages or issues that may arise as a result of having the brow lamination procedure performed on me.*
I understand that some irritation, itching or burning may occur to the skin which comes in contact with the lamination agent*
I understand that an allergic reaction is possible.*
I understand that it is imperative that I disclose all of the information requested on the client intake form.*
I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications.*
I consent to “before and after” photographs for the purpose of documentation, potential advertising and promotional purposes.
I agree that if I experience any ill effects with brows that I will contact the technician that performed this procedure.*
I understand that brow lamination is the process of restructuring the brow hairs to keep them in a desired shape, but it is my responsibility to brush my brows daily to maintain the desired look.*
I understand that I need to keep my eyebrows dry for 48 hours after the brow lamination process.*
I understand that brow lamination is not recommended for people with the conditions highlighted above, which I confirmed do not apply to me.*
This agreement will remain in effect for this procedure and all future follow-ups conducted by the technician. I understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to brow lamination procedure.

I have completed the form to the best of my ability and knowledge. I agree to inform the technician of any changes in the above information. I agree that I do not have any conditions that would make the requested treatment unsuitable. I will inform the technician of any discomfort I may experience at my time during my treatment to allow them to adjust accordingly. I agree to waive all liability toward my technician and the salon for any injury for damages incurred due to any misrepresentation of my health.
Client Signature*
Should be Empty:

Brow Lamination Client Consent Form

Brow History

Medical History

Please note, we cannot perform this service if you are pregnant.

Please note, we cannot perform this service if you are currently using Retinol, Accutane, AHAs or BHAs.

Client Consent