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PMU Consent Forms

This form is designed to provide information needed to make an informed choice of whether or not to this process and/or technique would be befitting for you.                            

Potential clients must be 18+, not pregnant or breast feeding, no major health conditions.

Please refrain from the consumption of CAFFINE, ALCOHOL, ASPINS OR FISH OILS FOR 24 HOURS PRIOR TO APPOINTMENT. These products increase the chances of sensibility and bleeding.

 

Deposits are required prior to booking and will be applied to total price of completed service. Cancellations and/or changes can NOT be made within 48 hours of your scheduled service. If you opt to cancel your appointment within 48 hours, you forfeit your deposit and must rebook according to availability.

 

You are allowed to reschedule your microshading services up to 2 times in a 30-day timeframe. If you attempted to reschedule a 3rd time and/or outside of 30 days, you forfeit your deposit and must rebook according to availability.

All initial permanent makeup services REQUIRE a touch up appointment, otherwise your brow/lip services are not complete!

 

Procedure Acknowledgments and Risks

 

PAIN: Even after topical anesthetic has been used, there can be some discomfort/pain. Anesthetics’ effectiveness will depend on each person.

 

ALLERGIC REACTION: If there is a small chance of an allergic reaction, you may choose to take a 5-7-day patch test. Call 912.591.3258 to schedule.
 
EXCESSIVE SWELLING/ BRUISING: Some individuals bruise more easily than others. Ice packs will reduce swelling, typically lasting 2-5 days. Some people do not experience any swelling or bruising.

 

INFECTION: Although unusual, infection can occur. The affected area must be kept clean, and hands must be washed prior to touching. See “After Care Instructions” for more details. 

 

ASYMMETRY: Every effort is made to make brows as symmetrical as possible, but faces are not symmetrical. Adjustments may be necessary to correct any appearance of unevenness.

 

UNEVEN PIGMENTATION: This can result from poor healing, infection, bleeding or multiple other causes. Your touch-up appointment(s) will help correct uneven areas. MRI: Pigments used in permanent cosmetic procedures may contain inert oxides. This may require a low-level magnet when getting an MRI scan. You must inform medical personnel about your cosmetic tattoo.

I understand all the above is a possible risk with any and all cosmetic tattooing and there are no guarantees. This is a consent and release for procedures performed at “The Butterfly Effect Beauty Enhancements” by the Technician.

Consent and Release Agreement for Permanent Cosmetics

Please fill out the following form
in order to participate in our activity.

I understand that this process involves pigment being inserted into the epidermis (superficial layer) and is a form of tattooing. This is effective in most cases, but there is no guarantee that a specific client will benefit from the procedure.
I’m informed that all instruments that enter the skin or come in contact with body fluids are disposable and are disposed of after use. Cross contamination guidelines are strictly adhered to.
I am informed of potentially harmful or negative side effects that may be caused by this process, and release the PMU Technician from all liability associated with this procedure. If I have any questions, I will contact the Technician.
I understand that the color will initially appear darker, compared to the end result. The color will fade 20-40% within a week and will soften/look more natural over time. A touch-up will be needed and required within 6-12 weeks.
During the first 14 days after the procedure, while the treated area is healing, I understand that following the Pre/ Post Care instructions is very important. A copy has been given to me, which I will follow to the best of my ability.
I understand that Retin-A®, Renova®, Tretinoin, Alpha Hydroxy and Glycolic acids must not be used on the treated areas. These products may alter the color.
I understand that tanning beds, sunbathing, pools, some skin care products and medications can affect the results.
I understand the risks associated with permanent makeup procedures, are: Fading, Fanning, Spreading OR pigment may migrate and agree to engage the services of the Technician.
I give permission to The Butterfly Effect iBrow Enhancements LLC to show my before and after photos and/or videos to other potential clients (e.g. Facebook, Instagram, company website, etc.)
Do you have previous permanent makeup on the designated area?
Upload File
Check any and all conditions that apply

Thanks for submitting!

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