Client Release Form

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I am over 18 years of age, I am not under the influence of drugs or alcohol, I am not pregnant or breastfeeding, and I wish to receive the indicated permanent cosmetic procedure. The general nature of cosmetic tattooing has been explained to me, as well as the specific procedure that is performed.*

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I have been informed of the nature, risks, and possible complications and consequences of permanent skin pigmentation. I understand that the skin pigmentation procedure carries known and unknown complications associated with this type of procedure, including, but not limited to, infection, scarring, inconsistent color, and pigment spreading, fanning, or discoloration. Corneal abrasions are a rare side effect, especially if I rub or scratch my eyes or apply contact lenses too soon after an eyeliner procedure. I understand that the actual color of the pigment may be slightly modified, due to the tone and color of my skin. I fully understand that this is a tattooing process and therefore not an exact science, but an art. I request the permanent procedures and accept the permanence of the procedure as well as the possible complications and consequences of said procedure.*

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I am over 18 years of age, I am not under the influence of drugs or alcohol, I am not pregnant or breastfeeding, and I wish to receive the indicated permanent cosmetic procedure. The general nature of cosmetic tattooing has been explained to me, as well as the specific procedure that is performed.*

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I release the technician from liability if I develop an allergic reaction to the pigment.*

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I understand that if I undergo any skin treatment, laser hair removal, plastic surgery, or other skin-altering procedures, it may result in adverse changes to my permanent cosmetics. I recognize that some of these potential adverse changes may not be correctable.*

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I have received pre- and post-procedure instructions and will strictly adhere to such instructions. I understand that failure to do so may jeopardize my chances of a successful procedure. If I am taking any medication for depression or any other mood-altering prescription, I will let my technician know. If I have ever had cold sores, I will consult and strictly follow my doctor's instructions before contemplating any permanent cosmetic procedure around my lips.*

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I am not experiencing respiratory symptoms such as cough, colds, fever or body weakness or have been or have been around people with covid 19/Illness*

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I don't have uncontrolled diabetes or uncontrolled high blood pressure.*

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I don't have active cancer, I'm not on life-threatening treatments, I have epilepsy, HIV, hepatitis, influenza, cardiovascular disease, or healing disorders.*

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I am not taking blood thinners, skin medications such as Accutane, or steroids.*

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I understand that refunds are not given under any circumstances. Prices are subject to change at any time.*

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I have not had coffee, energy drinks, or tea (2) days prior to the appointment.*

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I am not using or have stopped using whitening products such as retinol, vitamin C, niacin, or glycolic acid (1) week prior to the appointment. I haven't had Botox a month before and I won't do it a month after the procedure.*

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I understand that taking before and after photographs of such procedures is a condition of such procedures and may be posted on social media as content. I certify that I have read and initialed the preceding paragraphs and that I have explained to my understanding this consent, medical and procedural leave. I accept full responsibility for the decision to do this cosmetic tattoo work.*

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