By signing below, I agree that all the above information is true and accurate to the best of my knowledge

 

This form is designed to give information needed to make an informed choice of whether or not to undergo a 3D Eyebrow, Microblading, semi-permanent makeup application. If you have any questions, please don't hesitate to ask. By signing below, you are agreeing to the following: 

• I understand that Microblading and or shading are a form of semi-permanent tattooing. It is not permanent tattooing. All techniques use a needle and or blade, which inserts pigment either manually or by machine into the epidermis.
• I understand that topical numbing cream is used and in rare cases can cause a sensitivity reaction; I attest I have fully disclosed all allergies.
• I understand of the following possible, but rare risks:

Pain: There can be pain even after the topical anesthetic has been used. Anesthetics work better on some people than on others. Typically all clients report very minimal pain

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 instruction on care.

Uneven Pigmentation: This can result from poor healing, infection, bleeding, or many other causes. Your follow-up appointment will likely correct any uneven appearance.

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

Excessive Swelling or Bruising: Some people bruise or swell more than others. The swelling or bruising typically disappears in 1-5 days. Some people don't bruise or swell at all.

Anesthetics: Topical anesthetics are used to numb the area to be tattooed. Lidocaine, Prilocaine, Benzocaine, Tetracaine, and/or Epinephrine cream and/or liquid are used. If you are allergic to any of these, please inform me now. Lethargy and headaches are common after using some numbing agents

 

• The alternative to these possibilities is to continue to use traditional cosmetics and NOT undergo the Semi-Permanent Eyebrow procedure. By signing below, I consent to this procedure, understand all risks, and release any and all liability against Eudora Aesthetics & Microblading LLC and associated persons.
• I understand that I am fully educated on how to take care of my brows in the post op period and any medical care needed will not be covered by Eudora Aesthetics & Microblading LLC. Although Microblading is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure. Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual and advised to expect a Touch-Up after healing is completed. Smoking, excessive sweating, Anemia, Use of retinols or acids in the area, and direct sun exposure can cause undesirable effects to the tattooed eyebrows. Excessive bleeding, sensitive skin, oily skin, thyroid disorder and or medicationsvcan possibly cause the pigment to heal light, patchy, or fade easily.

• I understand that i will agree with final shape and color before the procedure starts. By starting the procedure, you agree to the shape, style, color, and have had all questions answered.

   

I understand that a certain amount of discomfort is associated with this procedure, and that swelling, and bruising may occur.

I understand that although the technique is performed correctly, it is considered semi permanent since it fades and exfoliates out with the skin over time, strokes and markings are considered permanent by nature and by the Health Department

I understand that successful color saturation can NOT be guaranteed due to hidden scar tissue.

I acknowledge that the proposed procedures(s) involve risks inherent in the procedure, and have possibilities of complications during and/or following the procedures such as: infection, misplaced pigment, poor color retention, hyper-pigmentation, scarring, bleeding

 

Touch- Up Procedure (6-12 weeks after initial session): 

I have been advised that a touch-up session is required to make any adjustments to shape, color, and to fill any pigment that may have had poor retention. Touch- ups must be completed within 90 days (12 weeks) of initial procedure or a $100 fee applies. Microblading is a two step process. The first session usually retains 50-80% of strokes and pigment and vastly depends on skin type and after care. It is common for healed results after the first session to be light or patchy. The touch up session is necessary to make any desired changes and re-implant the pigment that was lost. If the client wishes to make dramatic changes at the touch up, with shape, thickness, or color, an additional touch up session for $85 may be needed. 

I certify that I have read or have had read to me the contents of this form. I understand the risks and alternatives involved in this procedure(s) I have had the opportunity to ask questions, and all of my questions have been answered. I acknowledge that I have reviewed and approved the material given to me, and I authorize this procedure