Brow Wax, Tint & Lamination Consent Form

Although every precaution will be taken to ensure your safety and well-being before, during, and after your brow lamination, wax and/or tint, please be aware of the following information and possible risks.

• I understand that there are risks associated with having a brow lamination.
• I understand that as part of the brow lamination and/or tinting procedure, skin irritation, skin pain, skin itching, discomfort, and in rare cases, skin infection could occur.
• I agree that if I experience any of these conditions with my eyebrows or surrounding skin, that I will contact my esthetician; if I choose to consult a physician, it will be at my own expense.
• I understand that the instruments, tapes, cleaners, adhesives, and/or removers may irritate my skin or require a physician’s follow-up care, even though my esthetician utilized correct techniques and followed proper safety protocols.
• I understand that a brow lamination will alter the density or texture of my brows. Depending on my natural brow shape and strength, results may vary.
• I understand and agree to the care instructions provided by my esthetician for the use and care of my brows after the treatment. I realize and accept that the consequences of failure to adhere to these instructions may cause the brows to not stay as laminated or tinted as long as originally told.

I agree to the following brow lamination and/or tinting care and maintenance instructions: No water can come in contact with the eyebrow area for 24 hours after the application.

This agreement will remain in effect for this procedure and all future procedures conducted by my esthetician.

I have read the above information. If I have any concerns, I will address these with my esthetician. I give permission to my esthetician to perform the brow services we have discussed and will hold her and her business harmless from any liability that may result from this treatment.

I have accurately answered the questions above, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.

In the event I may have additional questions or concerns regarding my treatment, I will consult my esthetician immediately.

I agree that this constitutes full disclosure, and that it supersedes any previous
verbal or written disclosures.

I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks.

I do not hold the esthetician, Ignacia Owen, responsible for any of my conditions that were present, but not disclosed at the time of this procedure that may be affected by the treatment performed today.

We would like your permission to use your photo for advertising and or social media. Your consent is necessary to do so.

I herby give my permission

A: to use, re-use, publish any photographic portraits or pictures of me.

B: I relinquish any right that I may have to examine or approve the completed product or products advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied.

C: I hereby affirm that I am over the age of 18 and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to this execution; I fully understand the contents thereof.

This agreement shall be binding upon me and my heirs, legal representatives and assigns.