Contradiction’s Form
Prior to booking your appointment, to ensure safety, each prospective candidate must review contraindications list and confirm that none of these conditions apply.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Appointment
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you Pregnant?
*
Yes
No
Are you Breastfeeding?
*
Yes
No
Do you experience Keloid scars?
*
Yes
No
Are you on Blood thinning medication?
*
Yes
No
Are you on Accutane or Retinoids? (Requirement: Must wait 6 months AFTER treatment)
*
Yes
No
Do you experience skin diseases?
*
Yes
No
Do you experience Irritations?
*
Yes
No
Do you have any open wounds?
*
Yes
No
Have you had Botox in 2 weeks to 4 weeks?
*
Yes
No
Do you have any old permanent makeup?
*
Yes
No
Do you have any broken capillary in eyebrow area
*
Yes
No
Have you been sunburned or tanning within 3 days
*
Yes
No
Have you had any Waxing or-tweezing within 3 days
*
Yes
No
Have you had any chemical peels/microdermabrasion within 2 weeks?
*
Yes
No
Do you have Rosacea? (microblading only)
*
Yes
No
Do you have any Cold sores, fever blister, Ocular?
*
Yes
No
Do you have Herpes?
*
Yes
No
Are you on any Antibiotics?
*
Yes
No
Submit
Should be Empty: