• Permanent Makeup Client Intake Form

  •  - -
  • Client Information

  •  - -
  • Requested Procedures Information

  • Medical History

  •  
  • TERMS AND CONDITIONS

  • It is my (the clients') responsibility to disclose any allergies or diseases.

    I agree to release the makeup artist from liability for any skin complications due to allergic reactions. 

    I understand that I will be in direct contact with various cosmetics and products topically applied.

    I am aware of the specific chemicals and/or cosmetics. 

    I totally understand and agree that these procedures is process requiring more than one applications of color to achieve wished results and 100% success is not guaranteed.


    I understand and accept that the color choices and color results in all procedures are not an exact science. 

    If I have a lens wearer, I know and accept that I must keep my lenses out the day of an eyeliner procedure.

    I understand and accept that these procedures may fade in time and this fading can change the original color pigmentation.

    I realize this is an elective cosmetic procedure and is not medically necessary.

    It is explained to me that the following possibilities may occur: minor or temporary bleeding, bruising, redness or other discoloration; swelling; fever blisters on the lip area following lip procedures and/or fading or loss of pigment.

    I give my consent to make up artist to discuss with my physicians for medical information required for the safety of my procedures.

    I am aware that if an infection occurs after I have had this procedure to see with my primary physician or an emergency room, immediately.

     

  • Clear
  • Should be Empty: