MICROBLADING DISCLOSURE & RELEASE FORM

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I understand the following completely: (initial each statement)

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______ 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.

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______ 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.

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______ 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.

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

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______ 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.

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

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

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

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______ 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.

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______ 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.

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______ 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.

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______ 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.

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_____________________________________________________________________________________________ Printed Name Signature Date