• Permanent Makeup Consent Form

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  • Date of Birth
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  • Date Signed
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  • Are you over the age of 18?
  • Do you have any of the following
  • Are you wearing contact lenses?
  • Are you pregnant or nursing?
  • Have you had botox less than 3 weeks ago?
  • Are you currently taking any medications? eg blood thinners.
  • Please understand that the process used to apply colour is not a one step process and may require subsequent visits to achieve desired results, your first initial touch up within 6 – 8 weeks will be included in your fee on your first visit.

    All instruments that enter the skin or meet body fluids are sealed and sterilized before use and disposed of after use. Cross contamination guidelines are strictly adhered to.

    Please understand the nature of the procedure and possible complications, reactions or adverse effects that may occur as a result of the applied pigments.

    Please understand with time the pigment can fade and will change according to metabolism, skin type, medication, age, smoking, alcohol, sun exposure, Retin-A Glycolic acids usage.

    Initially the colour will appear bold and vibrant compared to end result. Usually within 6 – 8 week period colour will fade 20% - 30%, soften and look 

    more natural. The pigment is semi-permanent and will fade somewhat over time and will likely need to be touched up through the years. Generally, 1-3 years depending on the aftercare of your newly micro bladed brows.

     

    POSSIBLE RISKS, HAZARDS OR COMPLICATIONS

    Pain: There can be pain even after the topical anesthetic has been used. Anesthetics work better on some people than others. Pain level is on a scale of 0 -10 (most feel 2).

    Infection: Infection is vey unusual. The areas treated must be kept clean and only touched with freshly cleaned hands or cotton swab.

    Uneven Pigmentation: This can result from poor healing, infection, bleeding or many other causes. Your follow up appointment will likely correct uneven appearance.

    Asymmetry: Every effort will be made to avoid asymmetry but our faces are not symmetrical so adjustments may be needed during the follow up session to correct and unevenness.

    Anesthesia: Topical anesthetics are used to numb the area to be micro bladed. Lidocaine, Prilocaine, Benzocaine, Tetracaine and Epinephrine in a cream or gel form are typically used. If you are allergic to any of these please inform me now.

    Iacknowledge that I have been given the opportunity to ask any questions about my procedure. I also aknowledge that all my questions have been anwsered to my full and total satisfaction.

    I have read and understand that contents of each paragraph above. I acknowledge that this is a contrat and that I have received no warranties or guarantees with respect to the benifits to be realized from, or consequences of, the aforementioned procedure(s). I further acknowledge that at the time of signing this consent to this procedure(s), I was of sound mind and capable of making independant decisions for myslef.

    Lyndsey Nolan shall perform semi permanent application of pigment to the skin of the releaser. whereas releaser has been informed as to the methods and procedures concerning the result of such treatments, a scratch test will also be performed prior to procedure, if requested by client, to detect and signs of alergies. I herby release, acuit and discharge Lyndsey Nolan and any and all persons which are or might be claimed to be liable to me from all claims and demands or whatever nature, actions and causes of action, damages, cost, loss of service, expenses and compensation on account or in any way growing out of personal induries and property damage to result at any time in the future, whether or not they are in contemplation of parties at present time and whether or not they arise following the execution of the release as the result of treatment procedure rendered. Releaser agrees to indemnify the hold harmless of Lyndsey Nolan for any loss, damage, claim, injury, or expense asserted against myself.

    Please also be aware that URBAN VANITY LOUNGE is in NO WAY affiliated with Better Brows by Lyndsey.

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