Brow Lamination Consent Form
Thank you for choosing Simply Wonderful Nails. Please complete the following consent form prior to your appointment.
Name
*
First Name
Last Name
Phone Number
*
Email
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Health History | Brow Lamination is NOT recommended if any of the following apply to you:
Psoriasis/severe eczema
Recent Eye Surgery
Alopecia, Recent Microblading (must be healed over 8weeks)
Sunburn
Super Sensitive Skin
Blood Thinners
Pink Eye
Scar Tissue in the Treatment Area
Pregnant/Breastfeeding
Retinol, Accutane, AHA, BHA, etc.
Current or Recent Chemotherapy Treatments (Doctor’s approval required in either case)
Please agree to the terms and conditions
*
Brow Lamination is a process of reconstructing the brow hairs to keep them in a desired shape and itis my own responsibility to brush them to achieve the desired look daily
After the Brow Lamination process, brows must stay dry for 24 hours.
Some redness of the skin or mild sensitivity is normal but does not typically last more than a fewhours.
Despite the use of the most high-quality ingredients, an allergic reaction is possible.
It is my responsibility to advise the esthetician of any concerns I may have prior to the BrowLamination procedure.
The minimum or maximum duration of the Brow Lamination cannot be determined with certainty.
Simply Wonderful Nails and the technician performing the Brow Lamination will not be held liable for anydamage caused to me or my eyebrows for any reason, including allergic reaction, skin sensitivity, orany damage caused to previous procedures such as prior henna/tint on the brow.
I give permission to Simply Wonderful Nails to perform a Brow Lamination. I have accurately answered thequestions above, and understand the risks associated with receiving the treatment. I agree that thisconstitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that Ihave read, and fully understand, the above paragraphs and that I have had sufficient opportunity fordiscussion to have any questions answered. I understand the procedure and accept the risks and will not holdliable Simply Wonderful Nails or the esthetician.
By signing here you confirm that all the information provided is correct and agree to all the terms and conditions
*
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