Information for PERMANENT MAKEUP procedure. informed consent form

PREASE READ CAREFUL!




BEFORE YOU COME IN


Dress comfortably and wear clothing that you may not mind getting pigment on, just in case. Bring a HAT or Visor.


Avoid these:


Aspirin or similar products, Alcohol, Niacin and Vitamin E, Ginkgo Biloba, Saint Johns Wart, Evening Primrose oil, green tea, ginger, tumeric, Omega fish oils, Blood thinning vitamins and medication will cause bleeding which may cause patchy healing or no color hold at all.


If you have any condition that requires you to take antibiotics prior to going to the dentist, it is a good idea to do the same prior to all tattoo work. Ask your Doctor.


Lips


Exfoliate your lips every day and night until your appointment. Take a buffer, or terry cloth and buff your lips, riding them of excess chapped skin.

If you have ever had a fever blister, cold sore, shingles or chicken pox, it is recommended you obtain a prescribed anti viral medication from your doctor or dentist. Fever blisters are very common as a side effect of lip tattooing.

All clients must be off Retin A or Renova 30 days prior to all procedures. One year off Accutane. Do not make an appointment for tattoo work if you just had BOTOX OR ANY FACIAL FILLERS. They may migrate away from the area of injection because I will be pressing firmly on the area around the brows, eyes and lips.


Eyeliner


Use new mascara, pencils and lipstick after all procedures.

Avoid sun tanning before and after your procedure. Including sun tanning booths.


Brows


Come in with plucked eyebrow hairs one week before procedure; I will not pluck them for you. I use a shaver to rid the unwanted area. Exfoliate the brows every night up to your appointment. This will get rid of built up sebum in the hair follicles.


Bring in a hat if you are planning to go shopping or driving in direct sunlight. This is an open wound and you can get 2nd degree burning if not protected. 

permanent makeup informed consent form Santa Maria Solvang Santa Ynez


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PLEASE READ CAREFUL!


INFORMED CONSENT FORM 

The nature and method of the proposed permanent makeup (cosmetic tattoo) procedure has been explained to me by IMPMU, including the usual risks inherent in the procedure process, and the possibility of complications during or following the performance. I understand there may be a certain amount of discomfort or pain associated with the procedure and that other adverse side effects may include minor and temporary bleeding, bruising, redness or other discoloration and swelling. Fever blister may occur on the lips following lip procedures in individuals prone to this problem. Fading or loss of pigment may occur. Secondary infection in the area of the procedure may occur, however if properly cared for, is very rare.

  • I acknowledge that hyper-pigmentation (darkening of the skin) or Hypo-pigmentation, (absence of color in the skin), or scarring is a possibility as a result of my body’s reaction to the skin being broken during the procedure. I realize that my body is unique and PMU technician cannot predict how my skin may react as a result of this procedure.
  • I understand that future laser treatments or other skin altering procedures, such as plastic surgery, implants and injections may alter and degrade my permanent makeup. I further understand that such changes are not the responsibility of IMPMU. I further understand that such changes in my appearance may not be correctable through further permanent makeup procedures.
  • I am aware that the Herpes Zoster I Virus (fever blisters, or cold sores) may manifest with the lip procedure due to trauma to the lip tissue. The anticipation of a Herpes Zoster l Virus break-out may be pre-treated with anti-viral medication, some of which are available by prescription only from your physician. If elected as a procedure I have been advised. 
  • I have been informed that medications that I am currently on may interfere with the deposit of color. IMPMU will deposit 100% color to my skin. Due to the chemical makeup of my skin or damage from the sun, my permanent makeup may need multi follow up visit, which will incur  additional charges to deposit more color in my skin. Cost to be determined by IMPMU. 
  • The fee for permanent makeup services has been explained to me and has been agreed upon. I understand the total fee for services rendered is due upon completion of the initial procedure and that there will be separate fees for any future modification of the original agreed upon procedure, including thicker liner, thicker brows and any color changes. The second visit is $90 up to two hours. Additional hour is $60
  • Second visit - TOUCHUP is the fine tuning of the first visit. To complete the pigmentation for a great result it may take as many hours as your first visit. Touchup price starts from $90 for the up to two hours, additional hour is $60.

Please note: Permanent Makeup is a two steps process. Your initial appointment is to lay the foundation of your permanent makeup. Rarely do we see optimal results after only the first treatment. The touch-up appointment is to fix any imperfections and generally the skin is more accepting of the ink in this appointment as well. Due to the nature of various skin, results can never be guaranteed but rest assured I will do everything in my power to make sure you leave here happy and confident.


Consultations - I do the same consultations at the beginning of a regular appointment, for everyone, I will not tattoo your brows until we are both comfortable and agree 100% to proceed with the pre-drawn brows. We could do a consultation appointment on its own but it will be an extra $30 for that consultation because its the exact process I would go through at the beginning of a regular appointment. (takes approx. 40 min)


Touch-ups - Policy is to book your touchup ($90) within 4-6 weeks after your initial appointment. I can be lenient for many circumstances if I am made aware of them. It is your responsibility to book your touchup within that time frame. Due to the unpredictable nature of different skin type responses to permanent makeup, should you deem a secondary touchup necessary for your own desired results, it will be $60 and must be booked 4-6 weeks after the first touch-up. Any "touch-ups" booked after 12 weeks of the last procedure become a "color boost”($240).


A 24 hour cancellation notice is required to cancel or reschedule an appointment. If you fail to cancel your appointment within the 24 hours, you will forfeit your retainer fee and you will be billed 20% of your procedure, no exceptions. Time was blocked especially for you and cannot be replaced. An additional deposit will be required to make a new appointment. If 2 appointments are missed or cancelled, payment in full for services scheduled will be due prior to the scheduled date. We understand in life unforeseen circumstances do arise. If you have an emergency all the above may be waived based on a case by case scenario. Proof of the emergency must be provided. 


Do not be late. Please allow plenty of time for traffic and other unforeseeable circumstances. To avoid unfair delays to other clients, if you are more than 15 minutes late, it may be necessary to reschedule. If there are no other clients scheduled after you we may still keep your appointment or possibly schedule you later in the day. However, if it is a fully booked day and it isn’t possible to schedule you same day, you will have to pay an additional retainer fee to reschedule. Also, we do block plenty of time in between clients to cover any possible reason a clients procedure may run late. Unfortunately, there have been times a procedure will go longer than expected. In these cases I ask for your patience and understanding as it may be you who is in this situation.


If you show up to appointment and have previous cosmetic tattoos that the artist wasn’t aware of you may be denied as a client. You may also be denied of service if you arrive under the influence of drugs or alcohol, have a cold or flu, or are deemed to not be in good physical or mental condition to perform your procedure. If you are denied at time of your appointment again, you will need to pay another retainer fee to reschedule, you will forfeit your original retainer fee and you will be billed 20% of your procedure to the card on file.

  • Due to the fact that your approval is obtained prior to the design and implanted application(s) of this elective service, IMPMU employs a no refund policy. 
  • It has been explained to me that immediately after the procedure(s) is completed, the color will appear darker than when the procedure heals. It has also been explained that within a short period of time, during the healing process, the color will lighten.
  • I acknowledge that a receipt of written instructions advising me of the proper care of my procedure, will be given to me, and I recognize the absolute necessity for following these instructions handed to you before you leave.
  • I have read and understand the contents of each paragraph above. I have received no unrealistic warranties or guarantees with respect to the benefits to be realized from, or consequences of the aforementioned procedure(s)
  • Tattoo inks, dyes and pigments have not been approved by the Federal Food and Drug Admin. The health consequences of using these product are unknown.
  • I acknowledge by signing this consent form, I have been given the full opportunity to ask any and all question about permanent makeup procedures and processes from IMPMU.

No children under the age 18 are allowed in the procedure room.