Consent To Proceed With Microblading Technique Using Agreed Eyebrow Drawing

I with full consent to go ahead with eyebrow drawing treatment using Microblading technique.

Client Name :
Address.:

Permanent make up IS NOT recommended for any clients who are or have:

• Pregnant or nursing
• Diabetic
• Undergoing chemotherapy (consult your doctor)
• Viral infection and/or diseases
• Epilepsy
• A pacemaker or major heart problems
• Had an organ transplant
• Skin irritations or psoriasis treated area (rashes, sunburn, acne e.t.c.)
• Sick (cold, flu e.t.c)
• Had Botox in the past 2 months
• Used Accutane in the past year

1. Client/Model has completed health questionnaire.	YesNo
2. Client agrees to taking photos and using photos for advertising purposes.	YesNo
3. Client has understood the terms/conditions surrounding the warranty.	YesNo
4. Client informed in detail by Dee’s Beauty Salon about the specific risks of eyebrow drawing treatment using Microblading technique.	YesNo
5. Client has followed pre treatment care and fully understands and agrees with post treatment care.	YesNo
6. Client has no further questions.	YesNo

Client Signature:

Date: