Tattoo Removal Consent Form
I currently have an unwanted tattoo/permanent makeup. This tattoo is located on the _______________________ (area of the body). This area was last tattooed on ________________________(approximate date) by ________________________ (business or tecnhnician). The permanent makeup is unwanted because ___________________________________________________ (indicate shape, color,location). I would like my technician today to A.___ Remove the entire tattoo if possible B.____ Partially remove the tattoo (place an X where applicable.
I understand that several treatments may be required in order to try to achieve my desired result.I have not been givem any guarantees as to the quality of the removal results.
I understand there are many medical and esthetic options fo the removal of my tattoo or permanent makeup. I have decided to choose the Rejuvi removal technique at this time.
I understand the unwanted tattoo/permanent makeup may not be successfuly removed and that permanent scarring may result in the attempt to remove the unwanted tattoo/permanent makeup as well as hypertrophy and hypo-pigmentation or other damage to the skin which may be permanent.
I understand that removing tattoo/ permanent makeup is a difficult and complicated process. As a result, I will not hold the technician at Glam Body Sugaring Boutique,LLC responsible in any resultant failure to remove partially or fully.
Furthermore, I will Not hold the Business or technician, the distributor or manufacturer of the tattoo removal products used in the attempted tattoo remova/permanent makeup process, liable for any damages that may occur to my face or body.
I agree to photographs "before" and "after' to be taken and to conform to all rules and regulations established by the technician and business listed for unwanted tattoo/permanent makeup removal. I agree to follow all aftercare instructions.
I have been duly informed of the nature, risks, possible complications, and consequences listed above. I also understand that the above listed technician is not a medical doctor,and have neither asked nor received any guarantees or promises as to the results obtained.
I understand everyting listed above, have had all my questions answered,agree that it is all true and correct and by my signature below, I agree to the above.