Client Consent Form Microblading
Microblading Consent and Release Agreement
This form is designed to give information needed to make an informed choice of whether or not to undergo a 3D Eyebrow, Microblading, semi-permanent makeup application. If you have any questions, please don’t hesitate to ask. Although 3D Eyebrow Microblading is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure. This is the process of inserting pigment into the basal layer of the epidermis. It is a form of tattooing, though semi-permanent.
All instruments that enter the skin or come in contact with body fluids are disposable, and disposed of after use. Cross contamination guidelines are strictly adhered to.
Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual and advised to expect a Touch-Up after healing is completed.
Initially the color will appear more vibrant or darker compared to the end result. Usually within 5-7 days the color will fade 40-50%, soften and look more natural. The pigment is semi-permanent and will fade over time. Additional Touch-Ups are likely needed within 6 months to 2 years.
Client Medical History Form
The following must be avoided during all nine days post-microblading procedure:
Hot sauna, hot bath, or Jacuzzi
Sun tanning or salon tanning
Any laser or chemical treatments or peelings, and/or any creams containing Retin-A or Glycolic Acid on the face or neck
Picking, peeling, or scratching of the micro pigmented area in order to avoid scarring of the area or removal of the pigment
Performing tasks related to heavy household cleaning such as garage or basement cleaning where there is a lot of airborne debris
Drinking alcohol in excess, as it may lead to slow healing of wounds
Driving in open air vehicles such as convertibles, boats, bicycles, or motorcycles
Touching of the eyebrow area except for when rinsing and applying the post-care cream with a cotton swab
Before showering apply a layer or post-care cream to protect your eyebrows from moisture. During the shower keep your face away from the shower head
Itching and flaking may appear during the first seven days post-microblading procedure. However, experience has shown that by following these after-care instructions, these symptoms may quickly disappear.
The healing of deeper wounds might last between 14-21 days. Touch-ups and/or correction of the shape-design is recommended only after this period.
If you have any unexpected problems with the healing of the skin, please contact Luxe Lashes immediately to discuss further instructions.
Statement of Consent and Recitals:
What to Expect During and After Your Microblading Session
Your new temporary eyebrow will go through several phases during the healing cycle.
The pigment will appear very sharp and dark immediately after the procedure. This is because the pigment is still sitting on top of your skin, and has not yet settled in completely. The color of the pigment will soften gradually. Do not be alarmed if you see some pigment on the cotton swab, as this is excess pigment and/or body fluid that is naturally exiting your skin.
Once the healing of the skin starts taking place, it will look like dandruff flakes or dry skin. This might give you the impression that the color pigment is fading too quickly, however, this is just superficial color and dry skin being naturally removed from your eyebrows.
Once completely healed, always apply a layer of sunscreen SPF 30 up to SPF 50 on your eyebrows when exposed to the sun. Sun exposure might cause the color pigment to fade away more quickly.
You can now enjoy your beautiful new eyebrows!
Booking and Cancellation Policy
The following policy will be effective as of January 4, 2016:
A credit card will be required to be uploaded for all appointments. This information is secure and cannot be viewed by our staff. However, it will be charged through our online booking system in the event of a no-show or cancellation.
No-shows and any appointments cancelled within 24-hours of your appointment time will be charged 50% of the scheduled service price.
Re-lash appointments exceeding 3 weeks will be an additional $10 per week exceeded. Re-lash appointments exceeding 5 weeks will then be booked as a full set and charged accordingly.