Permanent Makeup Questionnaire & Consent Form



 

 Permanent Makeup (Nano Brows / Lip Blush)

 

Informed Consent & Agreement

 

 

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✦ Client Understanding

 

I understand that permanent makeup (PMU) is a form of cosmetic tattooing in which pigment is implanted into the skin to enhance the appearance of brows or lips.

 

I acknowledge that results are semi-permanent and will fade over time. Multiple sessions are often required to achieve and maintain desired results.

 

 

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✦ Skin Condition & Treatment Eligibility

 

I understand that the condition of my skin directly affects the outcome of my results.

 

I acknowledge that services will not be performed on skin that is compromised, including but not limited to:

 

Irritation, inflammation, or sensitivity

 

Excessive dryness or flaking

 

Dermatitis, eczema, psoriasis

 

Sunburn or recent sun exposure

 

Active acne, open wounds, or infections in the treatment area

 

 

I understand that if my skin is not in an optimal condition at the time of my appointment, my service may be rescheduled in the best interest of my results.

 

 

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✦ Results & Healing Expectations

 

I understand:

 

Healed results vary based on skin type, lifestyle, health, and aftercare

 

Areas of oiliness, dryness, or compromised skin may heal unevenly or lighter

 

Perfect symmetry cannot be guaranteed due to natural facial structure

 

Color will appear darker initially and soften during healing

 

 

I acknowledge that a perfect result is not guaranteed, and additional sessions may be necessary.

 

 

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✦ Procedure & Artist Discretion

 

I understand that my provider will use professional judgment throughout the procedure.

 

I agree that:

 

The provider reserves the right to refuse or stop the procedure at any time if skin response is not suitable

 

Adjustments to shape, color, or technique may be made to ensure the most natural and balanced result

 

 

 

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✦ Risks & Considerations

 

I understand that while every precaution is taken, possible risks include:

 

Redness, swelling, tenderness

 

Uneven pigment retention

 

Blurring or fading of strokes (especially in certain skin types)

 

Allergic reaction (rare)

 

Infection if aftercare is not properly followed

 

 

 

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✦ Pre & Post Care Responsibility

 

I agree to follow all pre-care and aftercare instructions provided to me.

 

I understand that failure to follow instructions may:

 

Impact my results

 

Increase risk of irritation or poor healing

 

 

 

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✦ Touch-Ups & Maintenance

 

I understand that:

 

A touch-up session is typically required to refine results

 

Long-term maintenance will be needed as pigment fades over time

 

 

 

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✦ No Guarantee

 

I acknowledge that permanent makeup is an artistic process, and while every effort is made to achieve the desired outcome, specific results cannot be guaranteed.

 

 

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✦ Consent

 

By signing below, I confirm that:

 

I have read and understand this agreement in full

 

I have disclosed all relevant health conditions truthfully

 

I give permission to proceed with the procedure under the conditions outlined above

 

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