NEW CLIENT MEDICAL HISTORY/CONSENT

I agree that all the above information is true and accurate to the best of my knowledge.

 

Pain: There can be pain even after the topical anesthetic has been used. Anesthetics work better on some people than others. Lip procedures are more likely to involve some pain.

Infection: Infection is very uncommon. The treated area is considered an open wound and should be treated as such. Please see "After Care" sheet in your aftercare bag for post op care.

Uneven Pigmentation: This can result from poor healing, infection, bleeding or picking at scabs while healing. Your follow up appointment will likely correct any 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 any unevenness.

Excessive Swelling or Bruising: Bruising and swelling may occur after treatment. Any brusing or swelling will subside in 1-5 days.

Eye Exposure: There is a small risk of eye injury when an eyeliner procedure is performed. To avoid corneal abrasion, Celluvisc, a thick eye drop is used to protect the eye prior to the procedure. Eye drops are used to cleanse and flush the eye after the procedure is complete.

Anesthesia: Topical anesthetics are used to numb the area to be tattooed. Lidocaine, Prilocaine, Benzocaine, Tetracaine and Epinephrine in a cream or gel form are typically used. If you are allergic to any of these you must list your known allergies in the medical history.

MRI: Because pigments used in permanent cosmetic procedures contain inert oxides, a low-level magnet may be required if you need to be scanned by an MRI machine. Please inform your technician of any tattoos or permanent cosmetics.

Fever Blisters: If you are prone to cold sores or fever blisters, (herpes simplex), there is a high probability that you will get them. It is advised that you call your doctor for a prescription antiviral to help prevent this from occurring 1 week prior to your appoitment.

Allergic Reaction: There is a small possibility of an allergic reaction. If you would like to TAKE a patch test you have to wait 5-7 days to see if you get a reaction. If you would like to WAIVE the test you take full responsibility for any allergic reaction and agree and forever discharge and hold harmless the technician, all employees, contractors, and the management of the permanent makeup studio from any and all claims of negligence, damages, or legal actions arising from or connected in any way with my tattoo procedure, and conduct used in my tattoo and assume all responsibility for decision made consenting to this permanent procedure.

 

 CONSENT AND RELEASE FOR PROCEDURES PERFORMED:

Consent and Release Agreement for Permanent Cosmetics

This form is designed to give information needed to make an informed choice of whether to undergo a permanent cosmetics application. If you have questions, please don't hesitate to ask. Although permanent cosmetic tattooing is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure. This is the process of inserting pigment into the dermal layer of the skin and is a form of tattooing. All instruments that enter the skin or come in contact with body fluids are sealed and sterilized before use and disposed of after use. Cross contamination guidelines are stickily adhered to. Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual to expect a touch-up after the healing is completed. Initially the color will appear much more vibrant or darker compared to the result. Usually within 60 days the color will fade 10-50%, soften and look more natural. The pigment is permanent but will fade somewhat over time and will likely need to be touched-up through the years.

AFTERCARE

• Clean eyebrows everyday with damp cotton pad and purified or bottled water until fully healed (It takes about 4-14 days for brows to fully heal)
• Keep eyebrows dry (avoid soaking in water; ex. swimming or sauna) when healing. When taking a shower make sure to put your head back SO the water slides backwards and not directly on brows.
• No exercising, tanning, waxing or threading. No makeup, eyebrow pencil, lotion or other facial products on the brows until fully healed.
• DRY HEAL (No ointments, lotions, oils, Vaseline on brows)
• Apply A&D ointment if they are too dry (ONLY if artist advises you to)
• Use a hat if you know you will be out in the sun for a while. Sun can significantly alter the color.
• Once they are fully healed applying sunscreen on brows is recommended.

 

WHAT'S NORMAL?

Swelling, itching, scabbing, light bruising and dry tightness.

Too dark and slightly uneven appearance. After 2-7 days the darkness will fade and once swelling dissipates unevenness usually disappears. If they are too light or still a bit uneven after 6 weeks, then we will make the proper adjustments during the touch up appointment.

Color change or color loss. As the procedure area heals the color will lighten and sometimes seem to disappear. This can all be addressed during the touch up appointment and is why the touch up is necessary. The affected area must be completely healed before we can address any concerns. This takes at least 6 weeks.

Needing a touch up months or years later. A touch up may be needed 1 to 5 years after the initial procedure depending on your skin, medications and sun exposure. We recommend a touch up 30 days after the first session) and every few years to keep them looking fresh and beautiful. Touch up sessions after 60 days will be current touch up rate at time of touch up. Failure to follow the after-care instructions may result in infections, pigment loss or discoloration.

 

I have read, understand and agree to the above instructions.