Microblading Consent Form Logo

  • Pre-treatment Advice and Procedures

    • Delicate or sensitive skin areas may swell or redden, it is advised not to make social plans on the day of the procedure or outdoor high impact activites a week after your appointment.
    • Artists prefer shaping and removing unwanted hair at your appoitnment. If you prefer the area to be treated in advance, i.e., tweezing or waxing, the hair removal should be done at least 48 hours prior to your procedure. Do not resume any method of hair removal for two weeks following the procedure. Electrolysis should be avoided at least five days prior to the procedure.  
    • Must refrain from dying eyelashes and/or eyebrows at least 48 hours before the procedure.  Wait one week after the eyebrow or eyeliner procedure before dying lashes or brows.  
    • If you are having lip liner done and have had previous problems with cold sores, fever blisters, or mouth ulcers, the procedure is likely to re-activate the problem. Your Permanent Cosmetic Technician can make recommendations to help prevent or minimize the outbreak. If you have visible sores, blisters, or ulcers on the day of the procedures we are unable to perform services. 
    • Do not use aspirin or ibuprofen for 7 days prior to your procedure.  
    • There must be a month between Dysport, Botox, or filler injections and permanent cosmetic services.
       
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  • as a client have requested that you describe the procedure so that I may make an informed decision whether or not to undergo the procedure. 

    You have described the recommended procedure to be used as Micro Pigmentation, the process of implanting micro-insertions of pigment into the epidermal layer of skin.  Micro Pigmentation / Microblading is a form of tattooing used for the purpose of semi-permanent cosmetic makeup.

    I voluntary select Michelle F. Martinez/Apprentice/ Student as my semi-permanent cosmetic technician to perform on my body the following procedure.

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  • Only fill out this bottom portion if you are under the care of a physician for a serious medical reason.

  • - Hyperpigmentation is the darkening of an area of skin caused by increased melanin.

  • **CAUTION THERE MAY BE RISKS ASSOCIATED WITH THE PROCEDURE OF COMMERCIAL BODY ART, WHICH INCLUDES PERMANENT TATTOOS, BODY PIERCING, AND PERMANENT COSMETIC APPLICATION, THAT MAY ADVERSELY AFFECT THE HEALING PROCESS IF YOU HAVE, OR HAVE HAD, ANY OF THE FOLLOWING CONDITIONS:

    DIABETES, HISTORY OF HEMOPHILIA (BLEEDING), HISTORY OF SKIN DISEASES, SKIN LESIONS OR SKIN SENSITIVITIES TO SOAP, DISINFECTANTS, ETC., HISTORY OF ALLERGIES OR ADVERSE REACTIONS TO PIGMENTS, DYES, OR OTHER SKIN SENSITIVITIES, HISTORY OF EPILEPSY, SEIZURES, FAINTING, OR NARCOLEPSY, PREGNANCY OR BREAST-FEEDING/NURSING, IMMUNE DISORDERS, OR SCARRING (KELOID).”

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  • Medical History Form

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  • Do you have or have you ever had any of the following conditions? (MUST ANSWER YES or NO): 

  • **Beso Makeup shall not perform services on a person who is inebriated or incapacitated by the use of alcohol or drugs. Services will not be performed on persons with sunburn or other skin diseases or disorders (i.e., open lesions, rashes, wounds, punctured skin), psoriasis, or eczema present in the treatment area.

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  • Post Procedure Instructions

  • **You will receive a copy of post procedure instructions after your procedure is complete.

    For 7-14 days following application of permanent cosmetics: *Typical healing time varies on a person by person basis. An average of 7-14 days is needed for treated area to completely heal.


    Properly cleaning the treated area is essential for retaining pigment and preventing infection. If treated area is not continuously cleaned dead skin will build up, producing hard scabs causing rapid pigment loss.

    Before cleansing thoroughly wash and dry hands. Use fingertips to gently clean treated area twice a day with a soft anti-bacterial soap. *(Recommended Cleansers: Cetaphil, Johnson’s hypo-allergenic baby wash, Dial Foaming Anti-Bacterial soap).

    After you have gently cleansed the intradermal cosmetic area with a mild antibacterial soap or coconut oil, use your fingertips to rinse with water and lightly pat the area dry.

    Do not rub or pick at the epithelial crust; allow dead skin to flake off naturally. Absolutely no scrubbing, exfoliates, cleansing creams, or harsh chemicals.

    Apply A&D ointment, Hustle Butter, or coconut oil sparingly twice DAILY after cleaning until the procedure area has healed. Use a clean cotton swab to carefully blot ointment; do not use your fingertips.

    Do not expose treated area to water pressure in the shower. DO NOT clean treated area during or directly after bathing. Heat from water or steam helps to relax and cleanse pores making skin prone to pigment loss. Wait at least an hour and a half after bathing to clean treated area or clean before bathing.

    Do not soak treated area in bath, swimming pool or hot tub. Do not swim in fresh, salt or chlorinated pool water. Refrain from spray tans, tanning beds, and high-impact activities for two weeks or until completely healed. If high-impact activities cannot be avoided use a sweat band to absorb perspiration.

    Do not expose treated area to direct sunlight.
    Facial sun block may be used after the procedure area has completely healed to prevent future fading of pigment color. (*Only for those frequently exposed to the sun)

    Avoid using sponges and makeup brushes while healing. If necessary, use clean fingertips to apply makeup, however, applying makeup to unhealed skin is not advised or recommended.

    Avoid sleeping on treated area while healing. If it is uncomfortable or difficult to refrain from sleeping on the area, use the Tegaderm Film. *Tegaderm film can be found at most drug stores in the Band-Aid aisle.

    If you are a blood donor, do not donate for 1 year following your procedure. (American Red Cross guidelines)


    **DISCLAIMER
    Failure to follow post-treatment instructions may cause loss of pigment, discoloration, or infection. Remember, colors appear brighter and more sharply defined immediately following the procedure. As healing progresses, color will lighten up to 60%. A follow-up/re-touch procedure may or may not be needed. If you feel as though a follow-up/re-touch is necessary, the best time to do so is within 45-60 days following the first procedure. You will be asked to schedule a follow-up at your first appointment. If follow-ups are not scheduled during the first appointment, we cannot guarantee a following appointment in the recommended time frame (45-60 days). Additional fees will apply for any and all appointments following the first procedure. All follow-up/re-touch appointments are $150.00 up to 3 months after the first appointment; NO EXCEPTIONS. Color boost are necessary in 6-12 months following the initial procedure to maintain color. Color boost starts from $250 + varies. Pricing is determined on a person by person basis at the discretion of the Permanent Makeup technician. 
     

    WARNING: In the event of an allergic reaction, infection, or abnormal inflammation/ swelling please contact the body art operator at 504-518-4461 or immediately seek emergency medical care or call 911.

     

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  • CREDIT CARD FEE

    CREDIT CARD FEE

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  • Beso Makeup Photo Release Form

     

    Please initial which consent you are comfortable consenting too. You may choose both options, and/or just one. 

  • Please keep in mind that the following advice will play a huge part in the way your results appear after you’re finished healing.

    Heart Conditions/Pace Maker/Defibrillator (No exceptions)

    If you are any of these medications, you will bleed and the pigment may not retain:

    Triflusal (Disgren)
    Clopidogrel (Plavix)
    Prasugrel (Effient)
    Ticagrelor (Brilinta)
    Ticlopidine (Ticlid)
    Cilostazol (Pletal)
    Vorapaxar (Zontivity)
    Dipyridamole (Persantine
    Coumadin)
    Pradaxia (dibigatran)
    Xarelto (rivaraxaban)
    Eliquis (apixaban)
    Savaysa (edoxaban)

     Shingles (No exceptions)

    If you’ve ever had Shingles on your face, Microblading will not be performed, as the procedure could cause a flare up

     

     Eczema, Psoriasis or Dermatitis in or around the brow area

    Constant flaking/itching/irritation/shedding of skin

     

    Oily or severely oily skin

              The hair strokes will appear more blended, solid or not retain as much

     

    Large pores on your forehead & in the brow area

    Pigment will blur/blend in large pores looking powdered

     

    Hemophilia-Bleeding Disorder

    Pigment may not retain

     

    Menopause (Considered)

    If you have hot flashes during the procedure, the pigment may not retain and the Microblading technician may have to stop the procedure

     

    Platelet Disorders - Aggregation Disorders

    An aggregation disorder is when platelets do not bind with fibrinogen and other proteins in order to stick to other platelets. As a result, the platelets cannot form a plug to stop the bleeding from a damaged blood vessel.

    Moles/Skin Tags in or around the brow area

    Pigment will not be put into anything raised.

     

    Piercing in the brow area

    Scars can cause the pigment to migrate

     

    Deep wrinkles in the brow area

    The hair strokes will not lay properly in the creases, giving the brow an uneven look

     

    Thyroid condition and taking medication for this condition

    Hypo, Hyper Thyroidism, Graves Disease, Hashimotos

     

    Fitzpatrick Skin types 1 (redheads/white skin/light eyes)

    Due to hyper-sensitivity the skin may not take the pigment well.

     

    On Accutane (acne medicine) within the last 6 months

     

    Auto Immune Disorder of any kind (MSRA, Lupus, HIV/AIDS or the like)

    Due to the medicines to treat these diseases, pigment will not retain

    (No exceptions for MRSA, can be highly contagious)

     

    NO FISH OIL 2 WEEKS PRIOR

     

    Extremely Thin Skin: Transparent or Translucent or very vascular

     

    Frequent Exercise

    Due to the frequent production of sweat(salt), the pigment WILL NOT retain, fade very quickly, appear blurred or change in color.

     

    EXERCISE:

    If you work out regularly (5-7 days a week), your eyebrows WILL fade very fast due to the production of salt/sweat. Salt is used to remove permanent makeup.  They WILL appear more powdered or blurred under the skin as well.  Microblading Techs reserves the right to refuse future services if she feels the results won’t be to the client's satisfaction.

     

    TAN:

    ABSOLUTELY NO SUN 30 DAYS AFTER (This means you cannot go out in sun with a hat and glasses on, this means no SUN or HEAT FOR 30 days at all) If you resume tanning, the results will fade quickly, heal darker, or not retain at all.

     

     

     

     

     

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  • Beso Makeup Strict 72 Hour Booking/ Cancellation/Rescheduling/No Show Policy

  • 72 HOUR CANCELLATION POLICY

    We have a Strict Booking/Cancellation/Rescheduling/No Show Policy. We Ask That You Call, Cancel, Reschedule or Make Any Necessary Changes At Least 72 Hours Prior To Your Scheduled Appointment by phone (504)518-4461. Any Cancellations/Rescheduling made within 72 Hours prior to your appointment will Result in a 100% Cancellation Fee. If you are a NO SHOW this will result in a 100% Collection Fee. If Your Appointment is Cancelled by the Business, It May Be Due to Not Confirming Your Appointment (Via by phone and/or text message) or An Invalid/No Credit Card on File. PLEASE NOTE WEDNESDAYS (CLOSED) WILL NOT COUNTTOWARDS OUR STRICT 72 HOUR CANCELLATION POLICY. Rescheduling Appointments Will Be Determined Upon Availability and May Result in Additional Costs. **If you are in your first or last trimester of pregnancy, please contact us to schedule your appointment. If you have received BOTOX treatment less than 30days before your scheduled appointment, please contact us to reschedule your appointment** We Will NOT Be Able to Service You If You're Running More Than 30 min Behind, Please Call Us to Reschedule your appointment by phone(504)518-4461. An Additional Late Fee of $50 WILL Be Applied if You Are More Than15 Minutes Behind. When booking with Beso Makeup an active Credit Card is required to be held on file to hold your appointment. Failure to provide a valid credit card at the time of booking will result in a cancellation of the appointment. If you Cancel/Reschedule and/or a No Show the Credit Card on file will be charged. If the payment does not go through you will not be able to reschedule and/or book another appointment until that payment is paid in full.

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