Consent Form

Please fill out the consultation and consent forms prior to attending your appointment. Thank you.

[[[["field6","contains","Other"]],[["show_fields","field8"]],"and"]]
1 Step 1

Microblading Consent, Waiver and Release Form

Survey
Yes
I am over the age of 18, am not under the influence of drugs or alcohol, am not pregnant or nursing and desire to receive the indicated procedure. The general nature of the specific procedure to be preformed has been explained to me. Later than 8 weeks or missed scheduled appointments, will result in an additional $150 fee.
I accept responsibility for determining the position, shape, and color of the brows as agreed upon during consultation. I fully accept that non-toxic pigments are used during the treatment and the result achieved may fade over time. I accept that pigment may stay in the skin indefinitely.
Upon completion, there may be swelling and redness of the skin that will subside within 1-4 days. In some cases, bruising may occur.
I have been informed that the highest standards of sterilization and hygiene are met; pigment containers and disposable needles are used for each individual client, procedure, and visit.
I understand that results may be altered due to: medication, skin characteristics (oily, thick or thin skin, dry, mature, sun damaged), skins pH balance, lifestyle (tanning/sun exposure, daily skin care regime, exfoliation), and aftercare.
I have been informed of the nature, risks, and possible complications and consequences of permanent skin pigmentation.
I understand and accept the permanent skin pigmentation procedure carries with it known and unknown complications and consequences associated with this type of cosmetic procedure, included but not limited to: infection, scarring, inconsistent color, spreading, fanning, or fading of pigment. I understand the actual color of the pigment may be modified slightly due to the tone of my skin. I release the technician from liability if I develop an allergic reaction to the pigment.
I fully understand this a tattoo process and therefore not an exact science, but an art. Every effort will be made to avoid asymmetry but our faces are not symmetrical.
I understand that if I have any skin treatments, laser hair removal, plastic surgery, or other skin altering procedures, it may result in adverse changes to my permanent cosmetic procedure.
I have received pre- and post- procedure instructions and I will strictly adhere to such instructions. I understand that my failure to do so may jeopardize my chances for a successful procedure.
I consent and authorize the use by Crystal Parsons (Vixens Beauty Den) of the specified photographs and/or videos, which are taken throughout my treatment. I understand these photos may be used on social media, website, and in-office for demonstrational and promotional purposes. I understand that I am not entitled to compensation for these photos and/or videos.
I will not slander Crystal Parsons (Vixens Beauty Den) in any online forum including but not limited to: Instagram, Facebook, and Twitter if I am unhappy with the results. I will contact Crystal and allow her to work with me to find a solution.
I understand that this procedure and future procedures are non-refundable and non-transferable nor is money given back for future removal of procedures.
I certify I have read and initialed the above paragraphs and have had explained to my understanding the consent and procedure permit. I accept full responsibility for the decision to have this cosmetic tattoo work done.
keyboard_arrow_leftPrevious
Nextkeyboard_arrow_right
FormCraft - WordPress form builder
BY APPOINTMENT ONLY
WORKING DAYS 8:00 – 20:00 & SUNDAYS 8:00 – 16:00
BOOK NOW

VIXENSBEAUTYDEN@GMAIL.COM

SAY HELLO!

705-716-1336

BOOKINGS / INFO

298 NELSON ST, BARRIE, ON

FIND THE DEN