CONSENT FORM | Microbladingbytamila

PERMANENT MAKEUP CLIENT INTAKE & ACKNOWLEDGEMENT FORM

First name

Last name

Phone

Birthday

Month

Day

Year

PROCEDURE SELECTION

EYEBROWS(Microblading/Ombre/Combo/Nano)

LIP BLUSHING

OLD WORK / PMU COVER-UP

PREVIOUS PERMANENT MAKEUP DISCLOSURE

I do NOT have any previous permanent makeup in the area being treated.

I have previous permanent makeup performed by THIS artist/studio.

I have previous permanent makeup performed by another artist.

I understand that previous work performed by this artist/studio is acceptable and does not require additional approval unless requested.

I understand that if I have previous work performed by another artist, I am required to submit clear photos prior to booking for approval. Failure to disclose previous work or submit required photos may result in appointment cancellation and loss of deposit.

MEDICAL & ALLERGY DISCLOSURE

Please list any medical conditions, sensitivities, or allergies, including latex, pigments, numbing agents, medications, or skincare products

COLD SORE (HSV) DISCLOSURE — LIP PROCEDURES ONLY

I have had cold sores before

I am unsure if I have had cold sores

I have never had cold sores

I understand that preventative antiviral medication is required if I am prone to cold sores and that failure to take it may affect healing and final results.

I understand that permanent makeup is a cosmetic tattoo procedure and that results vary based on individual skin response, lifestyle, existing pigment, and aftercare compliance. I acknowledge possible risks including swelling, redness, pigment changes, delayed healing, or the need for additional sessions.

I agree to follow all aftercare instructions and understand that deposit, cancellation, and no-call/no-show policies apply as outlined on the website.

I acknowledge by signing this release that I have been given the full opportunity to ask any and all questions which I might

have about obtaining permanent make-up from Microblading by Tamila (hereafter called “Technician” and that all of my questions have been answered to my full and total satisfaction.

Client Signature

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