Permanent Makeup and Tattoos

Do you have moles/raised areas in or around the treatment area? Do you have or have you had a piercing in treatment area? Are you currently wearing lash extensions of any kind? Have you experienced Botox, Restylane or Collagen injections?

By signing below, you agree to the following: I have completed this form truthfully and to the best of my knowledge. I agree to waive all liabilities toward my technician and the employer for any injury or damages incurred due to any falsification of my medical history. I confirm that a single use, sterile tattoo needle in a sealed package was presented to me, opened in front of me, and I was informed that only approved ink handling procedures would be used.

I hereby consent to and authorize following procedure:

I confirm that I am above 18 years of age and affirm that I am not under the influence of drugs or alcohol. I further declare that I am not pregnant or nursing and express my desire to undergo the specified semi-permanent pigmentation procedure. I have received a comprehensive explanation regarding the general nature of cosmetic micro-pigmentation, as well as the specific procedure that will be carried out.

If any unforeseen condition arises during the procedure, I authorize my therapist to use their professional judgment to determine the necessary course of action under the circumstances. I take responsibility for selecting the color, shape, and placement of the Permanent Makeup procedure, as discussed during the consultation. I understand and acknowledge that non-toxic pigments are used during the procedure and that the achieved result may fade over a period of 1-3 years. Even as the color fades, the pigment itself may remain in the skin indefinitely.

Ihave been informed that strict hygiene standards are followed, including the use of sterile, disposable needles and pigment containers for each client, procedure, and visit.

I understand and accept that achieving the desired results is a process that may require multiple pigment applications, and that complete success cannot be guaranteed during the initial procedure. It may be necessary for me to return for additional procedures.

The outcome of the procedure can be influenced by various factors, including medication, skin characteristics (dryness, oiliness, sun damage, thickness or thinness), personal skin pH balance, alcohol consumption, smoking, and post-procedure aftercare.

After the procedure is completed, there may be temporary swelling and redness of the skin, which typically subsides within 1-4 days. Bruising may also occur in some cases. I can resume normal activities, but should limit the use of cosmetics, excessive sweating, and sun exposure until the skin has fully healed. Further instructions regarding aftercare will be provided. The results of the procedure should be acceptable for me to appear in public without additional makeup.

PERMANENT MAKEUP CLIENT CONSENT FORM

I agree to follow all pre-procedure and post-procedure instructions provided and explained to me by the technician. Failure to comply with these instructions may compromise the success of the procedure.

I acknowledge that I have received information regarding the nature, risks, and possible complications and consequences of permanent skin pigmentation. I understand that this cosmetic procedure carries both known and unknown complications, including but not limited to infection, scarring, inconsistent color, and the potential spreading, fanning, or fading of pigments. I am aware that the actual color of the pigment may be slightly modified due to the tone and color of my skin. 

I am fully aware that the semi-permanent skin pigmentation procedure is a form of tattooing, which is an art rather than an exact science. I am requesting this procedure with an understanding of its permanence and the possible complications and consequences associated with it.

I acknowledge that there is a possibility of having an allergic reaction to the numbing agent and/or pigments used during the procedure. While a patch test is offered, I understand that even if I undergo the test, it does not guarantee that I will not have an allergic reaction. If I choose to waive the patch test, I release the technician from any liability in the event that I develop an allergic reaction to the pigment.

I am aware that if I undergo any skin treatments, injectables, laser hair removal, plastic surgery, or other procedures that alter the skin, it may result in adverse changes to my permanent makeup procedure. I understand that some of these changes may not be correctable.

My signature acknowledges that I have read and agree that I will adhere to all of the aforementioned statements that I have initialed.

I hereby grant and authorize grant the right to capture, modify, edit, reproduce, exhibit, publish, distribute, and utilize any photographs, videos, and/or audio recordings taken of me for lawful promotional purposes. These materials may include, but are not limited to, newspapers, flyers, posters, brochures, advertisements, press kits, websites, social media platforms, and other forms of print and digital communication. I provide this authorization without expecting any payment or other forms of consideration.

This authorization remains in effect indefinitely and applies to all languages, media, formats, and markets, whether currently known or discovered in the future.

I willingly waive any rights to royalties or other compensation arising from or related to the use of these photographs or recordings.

I acknowledge and accept that the materials created through this agreement will be the property of the and will not be returned to me.

from any liability, claims, or I hereby release and discharge the legal actions that may arise, including those made by myself, my heirs, representatives, executors, administrators, or any other individuals acting on my behalf or on behalf of my estate.

By signing below, I confirm that I have thoroughly read and comprehended the entirety of the release agreement stated above.

By signing below, I hereby acknowledge that I have completely read and fully understand the above release agreement