New Client Consent & Medicial Form

I {name} hereby grant permission to Erica Kane Aesthetics to take photographs and/or videos of my permanent makeup procedure before, during, and after completion. I understand that these photographs and/or videos may be used for promotional, marketing, or educational purposes, including but not limited to the following:

• Display on the Erica Kane Aesthetics website.
• Inclusion in promotional materials, brochures, or advertisements.
• Sharing on social media platforms, including Instagram, Facebook, and Tik Tok.
• Educational presentations or materials related to permanent makeup artistry.
   

I understand that my photographs and/or videos will not be used for any purpose other than those stated above. Erica Kane Aesthetics agrees not to disclose my identity in conjunction with the photographs and/or videos unless I provide written consent for such disclosure. Idenitifing marks such as the clients face, tattoos, birthmarks can be blurred or cropped out upon request.

I release Erica Kane Aesthetics, its employees, representatives, and any third parties acting under its authority, from any claims or liability arising out of the use of the photographs and/or videos as described above. I understand that I will not receive any compensation for the use of these photographs and/or videos. 

I acknowledge that the photographs and/or videos may be accessible to the public and that Erica Kane Aesthetics has no control over the subsequent use of these materials by third parties.

This consent is effective as of the date of signing and remains in effect indefinitely unless I provide written notice of revocation to Erica Kane Aesthetics.

I {name} hereby acknowledge that I have voluntarily chosen to undergo permanent makeup procedures with Erica Kane Aesthetics. I have been fully informed about the nature of the procedures, including their purposes, potential risks, and expected outcomes. 

I understand that permanent makeup involves the deposit of pigment into the skin to enhance or create a long-lasting cosmetic effect. The procedures may be performed in one or more sessions, and the duration and results may vary. I am aware that, as with any cosmetic procedure, there are potential risks and side effects associated with permanent makeup. These may include but are not limited to:

• Pain or Discomfort: The permanent makeup process may cause discomfort or pain during and after the procedure.
• Infection: There is a risk of infection at the site of application, especially if aftercare instructions are not followed diligently.
• Allergic Reactions: In rare cases, individuals may experience an allergic reaction to permanent makeup pigments.
• Uneven Color or Fading: Over time, permanent makeup colors may fade or become uneven due to factors such as sun exposure and skin aging.
   

I have disclosed any pre-existing medical conditions or concerns, including allergies, previous permanent makeup or tattoo procedures, or medications I am currently taking. I understand that it is important to follow the pre and post-care instructions provide Erica Kane Aesthetics to maximize the effectiveness of the permanent makeup and minimize potential risks.

I have been informed about alternative cosmetic procedures and have chosen permanent makeup based on my preferences and understanding of the procedures. I understand that the healing process may require the skin to scab and peel over the first fews weeks of each session.  

I hereby give my informed consent to Erica Kane Aesthetics to perform the permanent makeup procedures as described. I understand the potential risks and benefits of the procedures and agree to follow all instructions provided by the permanent makeup technician.

I release Erica Kane Aesthetics, its employees, and representatives from any claims or liability arising out of the permanent makeup procedures, except those resulting from negligence or intentional misconduct.

Appointment Attendance: Clients are responsible for attending their scheduled permanent makeup appointments at Erica Kane Aesthetics.

Cancellation and Rescheduling: If you need to cancel or reschedule your appointment, I kindly request at least a 48 hour notice before the scheduled appointment time. All clients receive an appointment reminder 96 hours before their appointment via email and/or text.

Cancellation or NCNS: Cancellations/Reschedules made with less than 48 hours notice will be subject to forfeiting your $50 booking fee and the credit card on file will be charged 50% of the total amount that was due for that appointment. The $50 booking fee must be paid before rescheduling a new appointment. No exceptions. If no payment is due at your appointment, you will still be charged $50(non-refundable) with the card on file.

Cancellations/Reschedules/No-Shows made within the same day of the appointment will be subject to forfeiting your $50 booking fee and the credit card on file will be charged 100% of the total amount that was due for that appointment. No exceptions. If no payment is due at your appointment, you will still be charged $100(non-refundable) with the card on file.

Rescheduling without Fee: Clients may request to reschedule their appointment with at least 48 hour notice without forfeiting their booking fee. You are only able to reschedule your appointment one time per booking fee charge. The second reschedule during your treatment plan will require you to pay another $50 booking fee. 

Booking Fee Forfeiture: A non-refundable booking fee is required to secure your appointment slot. This deposit will be applied towards the total cost of the permanent makeup procedure. Booking fees are forfeited in the event of a late cancellation or no-show, as per the terms outlined in this policy. You have up to 2 weeks to choose a new date for your appointment after a reschedule, or you will have to pay a new booking fee.

Card on File: A card must be on file when scheduling with Erica Kane Aesthetics. A Credit Card Agreement Form will be sent via email after you submit this form. Not having that agreement completed 48 hours before your appointment can result in you losing your booking fee. Any upcoming appointments with Erica Kane Aesthetics will be cancelled if not completed. The card that you add on file DOES NOT have to be used for your appointments, it's only for liability measures.

Communication of Changes: It is essential to communicate any changes in your availability promptly. This helps us manage our schedule effectively and accommodate other clients.

Accepted Payment Methods: I accept cash, credit/debit cards, Cherry/Afterpay/Affirm payment plans, Zelle, and Cashapp on appointment day. All booking fee(s) must only be paid via credit/debt card only. All payments must be made in full on the day of your permanent makeup appointment.

Zelle/Apple Pay/Cash= No Fee

Debit/Credit Card/Cashapp= 2% Fee

Afterpay/Cherry/Affirm= 4% Fee

Pricing: Permanent makeup pricing is based on various factors, including design complexity, size, and placement. The final cost will be discussed and agreed upon before the commencement of the permanent makeup process.

Changes and Modifications: Any additional area changes or modifications requested during the permanent makeup session may incur additional charges. These will be communicated and agreed upon before proceeding.

Refund Policy: All up-front payments, including the booking fee, are non-refundable. In the event of a cancellation or no-show, the booking fee is forfeited, and any additional fees incurred must be paid.

Shop Minimum Fee: A $200 shop minimum fee applies to all permanent makeup appointments, regardless of the size or complexity of the procedure.

Exceptions: Exceptions to this policy may be made at the discretion of Erica at Erica Kane Aesthetics under special circumstances. If you're needing to reschedule an appointment last minute due to sickness, please submit a copy of a doctors note to ensure your card on file will not be charged 50%-100% of the total amount.

Since you will be paying a booking fee, it covers all of your appointments under your treatment plan. The booking fee is only active for 12 months starting on the day that it's paid. You will be credited for your booking fee during your first or last session, unless stated otherwise.

 

By paying your $50 booking fee and scheduling an appointment with Erica Kane Aesthetics, you acknowledge that you have read, understood, and agree to the terms of this Booking Fee Policy.

 

If there are any issues or problem during your treatment plan, please contact Erica or Carla(Assistant): ericakaneaesthetics@gmail.com 615-542-7237 or 615-623-5045