MEDICAL HEALTH FORM

Alergies

Tick if you have you ever had an allergic reaction to any of the following:

Patch Testing for Allergies

(A) I understand that a skin test can determine within 24 hours if I will have a
reaction to the product, but that it is inconclusive as to whether I will have an
allergic reaction at any time in the future. I choose the waiver my option to an
allergy test and wish to proceed.


B) I have undergone/been offered an allergy test prior to my initial treatment
and thereby release the technician from any liability related to any allergic
reaction to applied pigment or other products, or at a later date.

Please fill out the following table with a tick to indicate if any of the following relate to yourself.

Please fill out the following table with a tick to indicate if any of the you relate to or have had any of the following:

I give my consent for semi-permanent make up work to be carried out, which is undertaken at my request

I give consent for my photos to be advertised on social media, websites, shown to other clients etc.

I give consent for my photos to be advertised on social media, websites, shown to other clients etc.

I have visually seen my pre drawn results and am satisfied with the shape and width of the brows. I give consent for the procedure itself to be carried out.

My procedure has been completed to my satisfaction and I have been given the opportunity to discuss any immediate concerns with my technician. I fully understand my aftercare instructions.

Thanks for submitting!