• Ombre Powder Brows Liability Waiver

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    2 digit month, 2 digit day, 4 digit year
  • By signing this waiver form, I acknowledge and confirm the following:

  • Do you consent or waive the patch test?
               

  • I consent to allow BLAIR NICHOLE ESTHETICS to consult with and evaluate me in order to determine if I am a good canidate for the OMBRE POWDER BROWS procedure. I understand that photographs will be taken and kept in my file. I agree that these forms have been completed truthfully and to the best of my knowledge and abilities. I understand the contraindications and possible side effects of OMBRE POWDER BROWS as discussed with staff members of BLAIR NICHOLE ESTHETICS. Furthermore, I agree to waive all liablities towards BLAIR NICHOLE ESTHETICS for any injury or damages incurred due to my misrepresentation of my health history.

  • Date
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    2 digit month, 2 digit day, 4 digit year
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  • Should be Empty: