Consent and Waiver for Eyebrow Drawing Using Microblading Technique
Mayone Bakunawa-Balbarin
PhiBrows Royal Artist DZMB16342
(Artist)
8431 55th Road
Elmhurst, New York 11373
(Client/model)
The Artist has informed the Client/model in detail about the eyebrow drawing treatment using the microblading technique, more generally described, to wit—
Eyebrow microblading, also known as 3D eyebrows, 6D eyebrow feathering, eyebrow embroidery, eyebrow cloning, etc., is a semi-permanent procedure where the Artist draws on individual hairs using a special pen with a tiny blade on the tip and pigments that match your natural hair color and skin tone.
To determine your eligibility as a candidate for the eyebrow drawing treatment using the microblading technique, please truthfully answer the following questions regarding your health. The client/model acknowledges and warrants that failure to provide accurate information, or omitting relevant information, will absolve the artist of any liability.
This information will be kept confidential and treated with the utmost discretion.
Please tick the box if the following statements apply to you:
Are you taking medication for blood thinning (anticoagulants)?
Are you pregnant?
Are you breastfeeding?
Are you near or on your period?
Do you have a pacemaker?
Do you have a history of problems with the healing of wounds?
Have you consumed alcohol in the last 24 hours?
Are you taking any medications on a daily basis?
Are you a heavy smoker?
Did you, in the last 14 days, undergo surgery, and/or get exposed to radiation or have any other medical interventions?
The Artist has explained the specific risks of eyebrow drawing treatment using the microblading technique and has informed the Client/model in detail. It has been specifically explained to the Client/model that—
1.Injury is possible during the treatment despite the Artist's expertise and precautions.
2.Allergic reaction is possible, though rare, despite using top-quality pigments.
3.Temporary symptoms such as swelling, redness, and itching may occur during and after treatment.
4.Depending on the Client/model's skin structure, small scabs and a loss of drawn hairs may occur after the first treatment, and the color intensity may change. The shape of the eyebrows is determined according to face proportion and symmetry and is determined digitally with closed eyes due to the varying effect of facial expressions.
5.Extremely oily or extremely dry skin may require two or more treatments, and a change in color intensity is possible. The minimum or maximum duration of the treatment and a warranty cannot be determined.
Consult or get clearance from a licensed dermatologist if in doubt about skin issues or allergies.
1.Permanent makeup works through a form of skin injury, so it's important to carefully nurture the skin after the treatment to avoid complications.
2.The Client/model agrees to adhere to the aftercare instructions given by the Artist, use only the cream/ointment provided, avoid makeup and other products, and avoid public bathing, sunbathing, and other activities that may affect the skin. Inadequate care in the healing phase of the skin can lead to poor results, and the Client/model agrees that the Artist shall not be liable for it.
3.To achieve optimal results, the Client/model must collaborate with the Artist and follow proper aftercare instructions. The Client/model agrees to be responsible for any negligence or improper post-treatment care.
The first follow-up or correction session for the eyebrow drawing treatment must take place within four to six weeks of the initial procedure. It is of utmost importance that the client returns for this session to reinforce or make any necessary corrections to the previous strokes. Failure to attend the follow-up session within the specified time frame may result in a premature fading of the strokes, and the client acknowledges and accepts that the artist shall not be held responsible for this outcome.
In the event that the client fails to return within six weeks and the microbladed strokes have completely disappeared, the client will be charged the full rate for a new treatment.
