Advised Consent form for Permanent Cosmetic/Medical

Permanent Cosmetic Procedure

PLEASE READ THE BELOW INFORMATION: 

I hereby authorise Laura Batchelder to perform upon myself a permanent cosmetic/medical enhancement. If any unforeseen condition arises in the course of the procedure(s) I further request and authorise her to use her full judgement and do whatever he/ she deems advisable and necessary in the circumstances.

I understand that permanent cosmetic/medical enhancement is an advanced

form of tattooing.


I accept responsibility for determining the colour, shape and position of the enhancement as agreed during the course of my consultation.

I understand that a sensitivity test for pigment does not guarantee that I will not have an allergic response. I am aware of that allergic response to pigment is rare and accept all responsibility if allergic response occurs.


I am aware that a sensitivity reaction to anaesthetics can occur and accept all responsibility if allergic response occurs.

I fully understand and accept that non-toxic pigments are used during the procedure and that the cosmetic enhancement achieved may fade over the course of 3 months -3 years. Even though the colour has faded, the pigment will stay in the skin indefinitely and may leave a light residue of colour.

I accept that the highest standards of hygiene are met, and that sterile disposable needles are used for each individual client, procedure and visit.

 

I understand and accept that each procedure is a process requiring multiple applications of pigment to achieve desirable results, and that 100% success cannot be guaranteed. I understand that this is why I need to return for a control procedure that is included in the initial price.

 

I understand that the control procedure, if required, will be performed 1-2 months after the initial procedure and that after a 2-month period I will be charged an additional fee for any procedures.

 

I understand that a control procedure takes place 6-10 weeks after the initial application to allow the procedure site to fully heal. I will book the appointment when it is convenient for both parties.

 

I understand that the pigment may migrate under the skin, however this is a rare occurrence.


I understand that permanent cosmetic enhancement is an invasive procedure and the infusion process can be uncomfortable.

Medication. Skin Characteristics - i.e. dry/oily/sun-damaged.

Natural skin undertones.

Alcohol intake and smoking.

General stress.

A compromised immune system.

Poor diet.

Post procedure care treatment

In some cases, bruising can occur. I have been advised that I can resume normal activities immediately following the procedure, however, using cosmetics, prolonged exposure to water, excessive perspiration and exposure to the sun should be limited for up to two weeks following the infusion process.

I understand that the true colour will be visible 1 month after each application, and that the colour may vary according to skin tones, skin type, age and skin conditions. Iappreciate that some skins accept colour more readily than others and no guarantee of an exact effect or colour can be given.

I absolutely understand that micropigmentation is an art process and is not an exact science and that every client heals differently. I understand that this is an elective procedure and is not medically necessary. I understand thatI will need to return for a second treatment before my procedure can be deemed complete. If heavy make-up

isrequired then I accept that I may require additional work, which I understand

is chargeable.

I understand that the second treatment needs to be taken – after one month and before three months. If I do not return in the agreed time scale it is deemed that I am happy with a single procedure and that I will pay for any further procedures taken thereafter. I understand that no money will be refunded to me should I decline the second treatment.

I confirm I will strictly adhere to the typed after-care instructions posted/handed to me, and only use the after-care products given. I understand that complications are possible, particularly if post-procedure aftercare instructions are not followed and if I get an infection post-procedure I will visit my Doctor immediately and accept that it could
be due to the fact that I do not live in sterile conditions. If I have any questions or queries after the procedure I will message or telephone the technician to discuss.

I fully understand that the skin type of every client is different and have been advised that pigment should stay visible in the skin for up to 2 years (and in some cases indefinitely). Also, that lighter colours will fade quicker than darker colours, and that colours might change with time. 

If considering BOTOX or COLLAGEN please note injectables can alter the position of the eyebrows.

I understand that future laser treatments or other skin altering procedures, such as plastic surgery, chemical peels, implants, and/or injectable may alter my semi-permanent make-up.

I understand that semi permanent make up fades over the time and annual retouches may be required in order to refresh the colour. Semi permanent make up fading depends on medication, skin characteristics (dry/oily/sun-damaged), natural skin undertones, compromised immune system, poor diet, sun/sunbeds exposure (use spf 50cream to protect quick fading), chemical peels, hormone changes.

Colour Boosts
0-3 months £0.00
3-6 months £50.00
6-11 months £100.00
12-18 months £150.00
18-24 months £275- £325
24 months + £275.00 - £325 (including a top up)

Your Signature

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Newport,

NP20 1LY

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m - 2:30pm
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