Brow Lamination New Client Consent Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Health History | Please check any of the following that applies to you
Allergies to hair dyes or brow dyes
Infection on or around the brows
Open wounds on or around the brows
Psoriasis on or around the brows
Eczema on or around the brows
Alopecia on the brows
Highly sensitive or reactive skin
Have you received brow lamination, tint or brow waxing services before?
Yes
No
Are you on Accutane or any acne medication?
Yes
No
Have you recently had brow tattoo procedure done in the past 3 months?
Yes
No
Are you currently using any skin products containing Retinol, Vitamin A, and/or AHA, BHA products? *If yes, please pause any AHA/BHA products for 72hrs prior to appt, Retinol/Vitamin A users at least 3 weeks prior to appt.*
Yes
No
Have you had a fake or spray tan done on your face in the past 48hrs?
Yes
No
Have you recently had facial treatments such as chemical peels, microdermabrasions, skin needling etc.?
Yes
No
If yes, which facial treatments?
Are you currently pregnant and/or breastfeeding?
Yes
No
Describe your dream brows. Don’t worry about the right terms, just explain what you like! Ex) more full & fluffy, clean & sleek, more defined shape, higher or straighter arch, natural & soft, darker tint etc. (unsure? I’ll guide you!)
ACKNOWLEDGEMENT & WAIVER
I consent to have pictures/videos taken of me, and to allow the photos to be used for Cessthetics media and marketing purposes (face masks can be provided)
I understand that this brow lamination procedure will result in a semi-permanent change in the structure of my eyebrows for the next 6 to 8 weeks. If i opt for the eyebrow tint, I understand that my eyebrows will be stained a different colour which will last up to 1 week on the skin and 4+ weeks on the hairs.
I understand that I may develop a reaction at any point during or after the service from the products used during my service. I accept that such a risk is possible. In the event where I develop a reaction during the service, I understand that my service may not be completed to ensure my safety. If I suspect a reaction arising post-procedure, I will contact my artist within 48 hours post-service.
I understand that results are not guaranteed and will vary per person and the state of my natural brows will factor into my results.
I understand that waxing will be a part of the procedure and that using certain skin products can increase the risk of injury to my skin. With that said, I consent to proceed with the waxing treatment and I have made my artist aware if I am currently using any products that contain exfoliants and/or vitamin-A such as but not limited to: Accutane, Retinol, AHA, BHA, Benzoyl Peroxide, Tretinoin, etc.
I understand that I need to follow proper aftercare guidelines to achieve maximum results.
If I find myself unsatisfied with my results, I understand that Cessthetics does not offer full-service discounts as the time and products that were used by my artist essentially cannot be "returned”
I confirm that the information I provided in this document is accurate & true
Date
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Month
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Day
Year
Date
Client Signature
Submit
Submit
Should be Empty: