PMU CONSENT

wynn beautiqué

PERMANENT MAKEUP CONSENT & INTAKE FORM
Name

First NameLast Name
Phone Number
Business Mobile: (714) 248-6247Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Email
wynnbeautique@gmail.com
Select the service type(s) you are requesting:
Have you previously had any permanent makeup procedures done in the area you’re booking for?
Please upload a clear, well-lit photo of your face, brows, or lips with no makeup applied.
Medical History
Provide more details if you answered yes to any medical conditions.
To achieve optimal results, you must follow the pre-care guidelines below
Numbing Consent
Risk Disclosure
Payment & Policy Agreement
- A $50 non-refundable deposit is required to confirm all permanent makeup appointments. This amount will be applied toward your final balance on the day of service. Cancellations or rescheduling must be made at least 48 hours in advance to avoid forfeiting your deposit.
- A 48-hour notice is required to cancel or reschedule without penalty.
- For best results, we recommend booking your touch-up 5–7 weeks after your initial session. Appointments beyond 7 weeks may require additional work and will be classified as a Color Boost.
- Clients with previous permanent makeup must receive prior approval. Clear photos are required before booking.
Photo / Video Consent

I grant permission to Wynn Beautiqué to take and use photos or video footage of my procedure and results for marketing, portfolio, and educational purposes. I understand that my identity will be respected, and photos may be edited to maintain professionalism.
Please list your desired appointment date(s), time(s), or general availability. I’ll reach out to confirm based on current openings.
Signature & Consent

By signing below, I confirm that:
- I have disclosed all relevant medical information
- I have read and understood all pre-care instructions, risks, and policies
- I consent to receive permanent makeup services from Wynn Beautiqué
Full Name
Today's Date

MonthDayYear
Date
Signature
If applicable, please provide your service address and share any questions or concerns below. I will be in touch within 24–48 hours to coordinate scheduling and secure your deposit.
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wynn beautiqué