• Brow Lamination Client Consent Form

  • Birthdate*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Would you like to be added to our email list for special discounts?

  • Brow History

  • Have you ever had your brows laminated?*
  • Have you tinted your eyebrows in the last 6 months?*
  • If yes, have you ever had an adverse reaction?
  • Have you ever had an allergic reaction to hair dye?*
  • Have you ever had an allergic reaction to a perm?*
  • Are your eyebrows microbladed?*

  • Medical History

  • Are you, or could you be pregnant?*

  • Please note, we cannot perform this service if you are pregnant.

  • Do you have, or are you being treated for any kind of eye injury?*
  • Do you have any allergies?*
  • Are you taking any medications or supplements?*
  • Are you currently using Retinol, Accutane, AHAs or BHAs?*

  • Please note, we cannot perform this service if you are currently using Retinol, Accutane, AHAs or BHAs.

    • Alopecia
    • Conjunctivitis
    • Currently taking blood thinners, brow growth serum, retinol, Accutane, or AHAs or BHAs
    • Eczema
    • Pregnant / Breastfeeding
    • Psoriasis
    • Recent eye surgery
    • Recent microblading
    • Retinol
    • Sensitive skin
    • Scar tissue in treatment area
    • Sunburn

  • Client Consent

    Although every precaution will be taken to ensure my safety and wellbeing before, during and after the brow lamination process, I am aware of the following information and possible risks:
  • I understand that during the treatment, despite all the precautionary measures, injury is possible. I will not hold the technician or business performing this services on me responsible in any way for any damages or issues that may arise as a result of having the brow lamination procedure performed on me.*
  • I understand that some irritation, itching or burning may occur to the skin which comes in contact with the lamination agent*
  • I understand that an allergic reaction is possible.*
  • I understand that it is imperative that I disclose all of the information requested on the client intake form.*
  • I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications.*
  • I consent to “before and after” photographs for the purpose of documentation, potential advertising and promotional purposes.
  • I agree that if I experience any ill effects with brows that I will contact the technician that performed this procedure.*
  • I understand that brow lamination is the process of restructuring the brow hairs to keep them in a desired shape, but it is my responsibility to brush my brows daily to maintain the desired look.*
  • I understand that I need to keep my eyebrows dry for 48 hours after the brow lamination process.*
  • I understand that brow lamination is not recommended for people with the conditions highlighted above, which I confirmed do not apply to me.*

  • This agreement will remain in effect for this procedure and all future follow-ups conducted by the technician. I understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to brow lamination procedure.

    I have completed the form to the best of my ability and knowledge. I agree to inform the technician of any changes in the above information. I agree that I do not have any conditions that would make the requested treatment unsuitable. I will inform the technician of any discomfort I may experience at my time during my treatment to allow them to adjust accordingly. I agree to waive all liability toward my technician and the salon for any injury for damages incurred due to any misrepresentation of my health.

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