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Acerca de

Marble Surface

DISCLOSURE RELEASE

MICROBLADING DISCLOSURE & RELEASE FORM

I understand the following completely: (initial each statement)

______ Microblading can last 6-18 months depending on how my skin reacts to the procedure. There may be fading and/or discoloration. The result may not be what I expected to receive. I understand this is a semi-permanent make up procedure that may take numerous follow-ups and touch ups to get desired results.

______ I must schedule the touch up within a 6-8 week period once my skin is healed. I have read and understand the Fees & Policies sheet.

______ I will see and agree with the pre-draw shape that my artist created before starting the procedure. I understand that this is a guideline for the shape and size of my brow design and it may vary slightly once the procedure is done.

______ There may be risks and hazards related to performing this procedure as it is a surgical procedure.

______ There may be discomfort and pain during the procedure.


______ There is a possibility of slight bleeding, swelling, redness, and allergic reactions to service.

 

______ Microblading is considered semi-permanent and can/will fade over time.

______ Microblading, though semi-permanent, may last permanently and may not fade completely.

______ Surgical procedures may be required to remove unwanted pigment from the skin. These procedures may cause scarring and permanent damage to the skin.

______ Final result cannot be determined until brows are completely healed (at least 5 weeks).

______ I understand that permanent and semi-permanent makeup procedures cannot be guaranteed and results cannot be predicted, as there are many variables that contribute to the final result.

______ I have received post care instructions and will follow them when I leave to ensure results of my procedure are satisfactory.

 

______ I am NOT pregnant or breast feeding.


______ I am NOT under the influence of drugs and/or alcohol or any other mind altering substance.

______ I fully understand all steps and guidelines and give permission to my technician to perform the service of Microblading and all procedure and steps involved.

______ I have truthfully filled out all forms and have also informed my technician of all medications I have taken or are taking.

 

______ I release Alexa Menard and licensed technician of all claims and injury, seen or unseen that may occur as a result of this procedure.

_____________________________________________________________________________________________ Printed Name Signature Date

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