Microblading or Permanent Makeup


 

 

Lavender-Falls-Stone-Oak-Spa-San-Antonio

Lavender Falls Face & Body Spa LLC

Client Informed Consent Form

Microblading - Permanent Makeup

 

PLEASE READ CAREFULLY & COMPLETELY

 

 

19239 Stone Oak Pkwy #201

San Antonio, Texas 78258

Phone: 210-446-0903

www.sanantonio.lavenderskinspa.com

Online Booking Available














 

 

 

 

 

 

 

Treatment Consists of:

Microblading or permanent makeup is the process of inserting pigment into the dermal layer of the skin and is a form of tattooing. All instruments that enter the skin or come in contact with body fluids are sealed and sterilized before use 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 to expect a touch-up after about 3 weeks and the healing is complete.

Client Acknowledgements:

**NO SERVICES WILL BE PERFORMED ON ANY PERSON WHO APPEARS TO BE UNDER THE INFLUENCE OF DRUGS OR ALCOHOL**

The procedure should not be performed if you have any lesions, irritation, or pimples. Moles should be removed prior, and need to heal 1 month before microblading.   If you are allergic to lidocaine, latex or If you are on blood thinners, Accutane or any Retinol. 

History – Do you presently have or previously had any of the following:

  Please check the following boxes to indicate if you have history of any of the following

 

 

 

 

 

 

 

 

 

*It is your responsibility to notify your aesthetician of any medical conditions & medications (Current & within the last 90 days).

 

I have received a copy of applicable written care instructions and I have read and understand such written care instructions:

 

 

 

 

 

 

Photography Release Consent

We would like your permission to use your photos for advertising. For example, our studio portfolios, online and print ads, etc. Your consent is necessary.

Please choose if you would like your photos used in advertising.

I Consent to the use of my photos for advertising purposes

 

 

 

 

 

 

Lavender Falls Face and Body Spa

Thank you for choosing and trusting Lavender Falls Face and Body spa for your aesthetic needs.

Feel free to contact us at 210-446-0903 if you have any questions

 

         

 

Lavender-Falls-Stone-Oak-Spa-San-Antonio

Lavender Falls Face & Body Spa LLC

Client Informed Consent & Release Form

Permanent Makeup -Microblading 

 

PLEASE READ CAREFULLY & COMPLETELY

 

19239 Stone Oak Pkwy #201

San Antonio, Texas 78258

Phone: 210-446-0903

www.sanantonio.lavenderskinspa.com

Online Booking Available

 

This form is designed to give information needed to make an informed choice of whether or not to undergo permanent makeup or 3D Microblading, semi-permanent technique. If you have questions, please don’t hesitate to contact us or ask your professional Artist.

 

      Although permanent makeup and 3D Microblading, semi-permanent technique is effective in most cases, absolutely no guarantee can be made regarding the client’s benefit from the procedure.

      This is the process of inserting pigment into the dermal layer of the skin and is a form of tattooing. All instruments that enter the skin or come in contact with body fluids are sealed and sterilized before use 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 to expect a touch-up after about 3 weeks and the healing is complete.

      Initially the color will appear much more vibrant and darker compared to the end result. Usually within 5 to 7 days the color will fade 40% to 50%, soften and look more natural. The pigment is semi-permanent and will fade over time and will likely need to be fully touched up within 2 years.

 

Here's a quick rundown of a typical service provided by a Lavender Falls Face and body Spa artist:

• First, the artist will need to do a patch test on the skin prior to the procedure.

• Before the appointment begins, the artist will provide a quick consultation to discuss expectations and results of the treatment.

• The artist then draws on the eyebrow shape by measuring and lining out eyebrows perfectly to complement your unique face shape & size.

• Next, you and the artist choose the perfect Brow color.

• A numbing agent is applied and will take 20- 30 min.

• Initial strokes are placed, and then an additional anesthetic/number is applied to reduce any discomfort.

• Pigment is worked into each stroke to define the brow.

• After, a pigment is rubbed in to absorb into the skin.

• Once that's finished, the artist wipes the area clean

• The pigment stroke may be repeated 3 times to make sure all areas are covered.

• After the service, the artist will apply an antiseptic ointment that will remain on the skin for several hours

Possible risks, hazards or complications Possible side effects include but are not limited to:

Possible side effects include but are not limited to:

• Pain: The service can be a little uncomfortable for those who are more sensitive. However, there is an anesthetic applied during to keep this to a minimum to where it is completely tolerable.

• Infection: Infection is very unusual. The areas treated must be kept clean and only freshly cleaned hands should touch the areas. See “After Care” sheet for instructions on care.

• Uneven Pigmentation: This can result from poor healing, infection, bleeding or many other causes. Your 3 week touch-up appointment will likely correct any uneven appearances.

• Asymmetry: Every effort will be made to avoid asymmetry but our faces are not symmetrical so adjustments may be needed during the 3 week touch-up session to correct any unevenness.

• Excessive Swelling or Bruising: Some people bruise and swell more than others. Ice packs may help and the bruising and swelling typically disappears with 1 to 5 days. Some people don’t bruise or swell at all.

• Eye Exposure: There is a small risk of eye injury when an eyeliner procedure is performed. To avoid corneal abrasion, Celluvisc, a thick eye drop is used prior to the procedure. Eye drops are used to flush the eye after the procedure is complete.

• Anesthesia: Topical anesthetics are used to numb the area to be tattooed. Lidocaine, Prilocaine, Benzocaine, Tetracaine and Ephinephrine in a cream or gel form are typically used. If you are allergic to any of these please inform me now.

• MRI: Because pigments used in permanent cosmetic procedures contain inert oxides, a low level magnet may be required if you need to be scanned by an MRI machine. You must inform your technician of any tattoos or permanent make-up.

• Allergic Reaction: There is a small possibility of an allergic reaction. You may take a 5 to 7 day patch test to determine this.

 

Acknowledgements:

      I understand that any time the skin barrier is compromised; there is a small risk of infection. I will contact my aesthetician immediately should this happen.

      The Microblading or permanent makeup treatment has been fully explained and any questions or concerns that I have, have been addressed.

      I acknowledge that no guarantee has been given to me as to the results expected following treatment, due to each individual’s unique reactions.

      I acknowledge this procedure is strictly an elective cosmetic procedure and that no medical claims have been expressed or implied.

      Photographs may be taken for comparison for future treatments for my chart.

 

I have read the above and understand it. My provider has answered my questions satisfactorily. I accept the possible risks and complications of the treatment.

 

I acknowledge that Lavender Falls Face and Body Spa has a no-refund policy on any products or service. There will be no refunds for any reason.

 

All services performed are without any guarantee. By continuing with service, you are confirming that you have read and understand our no refunds policy.

 

 

 

 

 

 

Lavender Falls Face and Body Spa LLC

Thank you for choosing and trusting Lavender Falls Face & Body Spa LLC for your aesthetic needs.

Feel free to contact us at 210-446-0903 if you have any questions

         

  

 

Lavender Falls Face & Body Spa LLC

Permanent Makeup or Microblading Aftercare Instructions

 

PLEASE READ CAREFULLY & COMPLETELY

 

19239 Stone Oak Pkwy #201

San Antonio, Texas 78258

Phone: 210-446-0903

www.sanantonio.lavenderskinspa.com

Online Booking Available

 

 

 

After care is very important for producing a beautiful and lasting result.

 

Please follow these after care instructions:

 

Aftercare:

 

      If there is any sign of infection immediately contact a doctor or medical professional.

       Keep the area clean by washing with freshly washed hands and a mild soap (Cetaphil gel). Do not use a washcloth or sponge to remove soap. Simply splash with water. Do not use cleansing creams, acne cleansers or astringents. Use Cetaphil gel or mild natural soap.

      For larger treated areas you will apply an aftercare balm (Aquaphor) for the first 12 hours only. Use a Q-Tip and apply a thin layer. Too little is better than too much. Blot off excess with a clean tissue. For standard microbladed eyebrows we will apply a medicated balm after treatment and you will not need to re-apply.

      Do not scrub, rub or pick at the epithelial crust that forms. Allow it to flake off by itself. If it is removed before it is ready the pigment underneath it can be pulled out.

      Do not use any make-up near the tattooed area for at least 5-7 days. Do not use mascara for tattooed eyeliner procedures for at least 5-7 days. Purchase new mascara and make-up if possible to avoid contamination or bacterial infection.

      It is recommended to use a sun block after the procedure area has healed to protect from sun fading.

      For at least two weeks, minimize exposure to the sun, and avoid swimming.

      The client shall consult a health care practitioner at the first sign of infection or an allergic reaction, and report any diagnosed infection, allergic reaction or adverse reaction resulting from the tattoo to the artist and to the Texas Department of State Health Services, Drugs and Medical Devices Group, at 1-888-839-6676.

 

Whats Normal?

 

      Mild swelling, itching, light scabbing, light bruising and dry tightness. Ice packs are a nice relief for swelling and bruising. Aftercare balm (Aquafor) is nice for scabbing and tightness.

      Too dark and slightly uneven appearance. 2-7 days the darkness will fade and once swelling dissipates unevenness usually disappears. If they are too dark or still a bit uneven after 3 weeks then we will make corrections or adjustments during the 3 week touch –up appointment.

      Color change or color loss. As the procedure area heals the color will lighten and sometimes seem to disappear. This can all be addressed during the touch-up appointment this is why the touch-up appointment is necessary. The procedure area has to be completely healed before we can address any concerns. The healing process takes about 3 weeks.

      Needing a touch-up months or years later. A touch up may be needed 6 months to 2 years after the touch-up procedure depending on your skin, medications and sun exposure. We recommend the 3 week touch-up and every 6 months to 2 years to keep your brows looking fresh and beautiful.

 

**Failure to follow after care instructions may result in infections, pigment loss or discoloration**

 

 

 

Lavender Falls Face and Body Spa LLC

Thank you for choosing and trusting Lavender Falls Face & Body Spa LLC for your aesthetic needs.

Feel free to contact us at 210-446-0903 if you have any questions

  I certify that the information entered above is true and correct, and that I have read, understand and agree to the aftercare instructions and terms and conditions

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Document name: Microblading or Permanent Makeup
lock iconUnique Document ID: 90402ed35c3baa3e17d2b82237ef08c140be803b
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April 8, 2017 9:04 pm CSTMicroblading or Permanent Makeup Uploaded by Lavender Falls Face and Body Spa LLC. - lavenderfallstx@gmail.com IP 162.198.97.65