Brow Questionnaire Form

Brow Questionnaire Form

Please fill out the form to ensure you are a good candidate! For all questions or concerns, please text/call: 310-880-2809 or Email: Contact@seduiresalon.com
Birthday

MonthDayYear
Date
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Nano BrowsNanoshading BrowsOmbre Brows
Yes, TEXT 310-880-2809 a photo of your brows for approvalNo
Date of appointment booked

MonthDayYear
Date
KrystalKatelynLinaJocelynClass Model
How did you hear about Seduire Salon?
If you have a skin condition on or near your eyebrows. This includes eczema, shingles, rashes, keloid or anything else near eyebrows.If you have had any trauma near your brows (car accident, head injury, etc)Those with allergies to alcohol, nickel or numbing agents. If you think you might have an allergy to our ink, numbing cream, or alcohol (which is in the ink), then you may have a reaction to our work.If you are under the age of 18. (Client's must be the age of 18+ to proceed with an appointment)If you are diabetic, anemic or have any blood deficienciesIf you are prone to keloidsIf you are prone to post-inflammatory hypo-pigmentationBlood Deficiencies such as HIV or Hepatitis are suggested not to proceed with the procedure. Due to difficulties of the body being able to fight infections, it would be in your best interest not to move forward with a procedure. Semi-permanent will cause numerous of injuries to the skin during ink application, so it will be a high risk of infectionChemotherapy (Although PMU is great for restoring eyebrows, a clearance letter is required by your doctor)If you have an autoimmune disorder.If you received botox or fillers in the brow or forehead area within the last 30 daysIf you have a history of rosacea or currently experience rosacea.If you’ve have had a brow lamination within the past six (6) weeks.If you’ve undergone a brow transplant and/or any brow or forehead lifting procedures.NONE OF THESE ABOVE APPLY TO ME
Pregnant (Due to retention and safety reason, we do not suggest anyone that is pregnant to move forward with any semi permanent procedure.)Breastfeeding (If breastfeeding, you must wait after you stopped breastfeeding and your first mensural cycle arrives)I am not pregnant or breastfeeding
Do you have any skin or health concerns we need to note for?
Please list any prescribed medication you are on:
90 days before: Avoid botox in the brow/forehead area, skin exfoliants, laser or chemical peels2 Weeks before: Avoid tweezing, waxing, electrolysis, retinol and dying your brows.72 Hours before: Avoid ALL Blood thinners; Aspirin, Ibuprofen, Caffeine (including tea), Smoking, Alcohol, Soda, etc. IF supplements such as fish oil, caffeinated drinks or any blood thinners are a part of your daily consumption, it is HIGHLY recommended to reduce intake two weeks prior and consume more water. Then discontinue completely the week prior to the appointmentMenstrual Cycle: Please be aware, if you are on or near your menstrual cycle, more bleeding may occur and you may be sensitive to pain due to your hormones in your bodyFAILURE TO FOLLOW PRE-CARE INSTRUCTIONS MAY AFFECT THE OUTCOME OF YOUR HEALED RESULTS BY 60-80%
POLICY:

COMMITMENT FEES & RESCHEDULING: All commitment fees are non-refundable. Services offered at Seduire Salon are primarily a “by appointment” business. All appointments require a 14 day pre-care preparation per appointment. Therefore, last minute rescheduling can have a negative impact on our technicians. We do our best to meet your scheduling needs and request that you adhere to our cancellation policy. Failure to reschedule within this time frame will result in a loss of your total commitment fee and a new commitment fee will be required to book another appointment. LET'S BE PUNCTUAL! Please respect others who have an appointment by arriving at a timely manner. We offer a grace period of 15 minute ONLY. Exceptions will not be made, as you are responsible for scheduling your time accordingly. All arrivals later than 15 minutes will result in a late fee of $40. If the time exceeds 30 minutes the late fee is $80 or a cancellation and an additional non-refundable commitment fee will be required to reschedule your appointment.
Signature
If you have any questions, please call or text: 310-880-2809
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