CONSENT FORM

CLIENT PMU CONSENT FORM
Permanent Makeup or Cosmetic Tattooing is a technique that applies permanent pigment into the dermis (skin) that allows a desired look to be achieved that resembles makeup. It can also be used to hide scars or help with an uneven hairline. This is preformed under a sterile environment.

Permanent makeup uses iron oxides that pigments the skin. This pigmentation can last between 1- 5 years. The pigment will gradually fade over time, however for most people it will not fade completely. 'Touch ups' of permanent makeup are advised usually after 3-6 months in order to achieve desired results.

With every treatment there are risks involved. It is important that you understand the risks prior to undergoing treatment. Ensuring you provide a full medical history can reduce these risks but even so there may be unforeseen risks that are presented. If you have any concerns regarding these risks, do not hesitate to contact your Healthcare Professional.

RISKS & COMPLICATIONS:
- Temporary Pain
- Scarring
- Bleeding
- Peeling
- Scabbing
- Allergic reaction
- Swelling
- Numbness
- Anaphylaxis
- Redness
- Infection
- Bruising
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Age *
Must be 18 and over. Age can also effect healing time length.
CONSENT: PLEASE CHECK ALL BOXES*

During the treatment, despite all the precautionary measures made by the Practitioner, injury is possible. I will not hold the Practitioner performing this service on me responsible in any issues that may arise because of having the procedure performed on me.I understand that there are risks associated with Permanent Makeup, if any sort of reaction occurs I will seek medical attention and inform my Practitioner.I understand that the color/outcome may not turn out as desired due to the undertone and health of my skin and that individual results will vary on each individual.I agree I have read over the ineligibility factors. It is my responsibility to advise the Technician of any concerns I may have before the procedure.I understand and agree to the pre and post care instructions provided by my Technician. By not following the aftercare instructions I am aware that the desired results may not be achieved.I understand the permanence of this procedure and my skin will be pigmented with iron oxides that may never fade completely.— I acknowledge and accept that no guarantees regarding the outcome of the procedure.The Technician performing the procedure will not be held liable for and damages caused to me or my skin by any reason, including allergic reaction, skin sensitivity, and failure to follow the after care instructions.I have declared all relevant history, and if any changes occur in the future I will notify my Technician.I confirm that the 6-8 week touch up is only included if I book within that timeframe. After that, I am aware I will have to pay for the touch up separately.I understand that this description of the procedure is not meant to scare or alarm me.—It is simply an effort to make me better informed so that I may give or withhold my consent for this procedure. I consent to the permanent makeup procedure being performed on me and accept that understand the risks and complications involved.
CLIENT FIRST & LAST NAME (PRINTED)*
CLIENT NAME (SIGNATURE)*

Clear
DATE*

MonthDayYear
Date
PHOTO & VIDEO RELEASE FORM
I hereby give permission for any photos, videos, or audio that are taken of me to be used in and/or for any lawful promotional materials, such as but not limited to newsletters, flyers, posters, brochures, advertisements, press kits, websites, social media pages, and other print and digital communications.

This authorization shall continue indefinitely and extends to all languages, media, formats and markets now known or later discovered

I renounce all claims I may have to royalties or other forms of payment resulting from or connected to the use of the image or sound recording.

I understand and agree that these materials shall become the property of technician and will not be returned.

All claims that I, my heirs, representatives, executors, administrators or any other person acting on my behalf or on behalf of my estate may hold them harmless and release them from any claims that they may bring.

By signing below, I hereby acknowledge that I have completely read and fully understand the above release agreement.
CLIENT FIRST & LAST NAME (PRINTED)*
CLIENT NAME (SIGNATURE)*

Clear
DATE*

MonthDayYear
Date
CANCELLATION POLICY
Our goal is to provide quality care in a timely manner. In order to do so, we have had to implement an appointment/cancelation policy.
Appointments are in high demand, and your early cancelation will give another person the opportunity to access to timely care. This policy allows us to better utilize available appointments for our clients.

At the time of booking your appointment you will be asked to pay an agreed upon deposit to be credited towards your treatment/s.

Time had specifically been reserved for your appointment. If you need to cancel or reschedule your appointment you must text/call at least 48 hours prior to your appointment and your deposit will be pushed once for a future appointment. However, providing less than 48' hours notice will forfeit your deposit.

If you arrive more than 15 minutes late for your appointment it is considered a no-show and your deposit will be forfeited.

We are happy to discuss any questions regarding this cancellation policy.

By signing below, I hereby acknowledge that I have completely read and fully understand the above Cancellation Policy. I agree to pay the cancellation fee in the event of a missed appointment.
CLIENT FIRST & LAST NAME (PRINTED)*
CLIENT NAME (SIGNATURE)*

Clear
DATE*

MonthDayYear
Date
What are your end goals for this service? *
i.e. Lips: more defined shape, even out natural color, brighter lip color. Brows: more symmetry, darker brows, more natural outcome, etc.
UPLOAD A CLEAR PICTURE OF YOUR BARE BROWS or LIPS*

Try to get a clear photo in good lighting & no makeup
Cancelof
Should be Empty:

CLIENT PMU CONSENT FORM

PHOTO & VIDEO RELEASE FORM

CANCELLATION POLICY