Have you had any of the following?
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Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzl, Alcohol, Carbopol, Lecithin, Propylene Glycol, Victamin E Acetate, Etc?
Allergies to metals, food, etc?
Any diseases or disorders not listed?
Do you use skin care products containing Retin-A, Glycolic Acid, or Alpha Hydroxyl? Please list any medications you are taking.
By selecting "I agree" I confirm that all the above information is true and accurate to the best of my knowledge.
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Consent and Release Agreement
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This form is designed to give information needed to make an informed choice of whether or not to undergo a 3D Eyebrow, Microblading, semi- permanent makeup application. If you have any questions, please don’t hesitate to ask.
Although 3D Eyebrow Microblading is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure.
This is the process of inserting pigment into the basal layer of the epidermis. It is a form of tattooing, though semipermanent, it is considered a permanent marking.
All instruments that enter the skin or come in contact with body fluids are disposable, and disposed of after use. Cross contamination guidelines are strictly adhered to.
Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual and advised to expect a Touch-Up after healing is completed.
Initially the colour will appear more vibrant or darker compared to the end result. Usually within 5-7 days the colour will fade 40-50%, soften and look more natural.
The pigment is semi-permanent and will fade over time. Additional TouchUps are likely needed within 6 months to 2 years.
Possible Risks, Hazards, or Complications
• Pain: There can be pain even after the topical anaesthetic has been used. Anaesthetics work better on some people than on others.
• Infection: Infection is very unusual. The areas treated must be kept clean, and only freshly cleaned hands should touch the areas. See “After Care” sheet for instruction on care.
• Uneven Pigmentation: This can result from poor healing, infection, bleeding, or many other causes. Your follow-up appointment will likely correct any uneven appearance.
• Asymmetry: Every effort will be made to avoid asymmetry, but out faces our not symmetrical so adjustments may be needed during the follow-up session to correct any unevenness.
• Excessive Swelling or Bruising: Some people bruise or swell more than others. Ice packs may help reduce the swelling. The swelling or bruising typically disappears in 1-5 days. Some people don’t bruise or swell at all.
• MRI: Because pigments used in Permanent Cosmetic procedures contain inert oxides, a low level magnet may be required if you need to be scanned by an MRI machine. You must inform your MRI Technician of any tattoos or permanent.
• Allergic Reaction: Although an allergy is unusual, there is always a possibility of an unknown allergy to the pigments and materials used during procedure.
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