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Pink Cream

Medical Profile/ Contradiction

Hemophilia
Yes
No
Diabetes II
Yes
No
Hepatitis A,B,C,D,E,F
Yes
No
Feverish infection/ Infectious illness
Yes
No
HIV positive
Yes
No
Skin anomalies in the treatment area ( warts, melanomas etc)
Yes
No
Immune system disorders
Yes
No
Epilepsy
Yes
No
Chemotherapy or irradiation
Yes
No
Surgery for a past 0.5 year
Yes
No
Acute heart/ cardiovascular problems
Yes
No
Conjunctivitis
Yes
No
Pregnancy/ nursing
Yes
No
Do you take any anticoagulant, blood thinning products?
Yes
No
To you knowledge are you allergic or resistant to numbing products?
Yes
No

Photos will be taken before and after the procedure. These photos may be used by the artist for social media, advertising, and promotional purposes. If you prefer to keep your photos private, you must inform the artist, who will still retain the photos for documentation and progress tracking.I acknowledge and accept that the proposed procedure(s) involve inherent risks and potential complications, including infection, misplaced or migrating pigment, poor color retention, and fever blisters.I understand that if I choose to change the color or shape after the initial application or at any time in the future, additional sessions may be required to achieve the desired result and color depth.I understand that there will be NO refunds after treatment for this elective procedure.I certify that I have read, fully understand, and voluntarily agree to the terms outlined in this consent form.

Contact information

Birthday
Month
Day
Year

Liability Waiver Consent Form a heading

  • I am over 18 years old and not under the influence of drugs or alcohol.

  • Permanent Makeup:

    • Permanent makeup, also known as cosmetic tattooing, involves depositing hypoallergenic pigments into the upper dermal layer of the skin to enhance or reconstruct features like eyebrows, lips, and areolas, or to disguise scars.

    • I understand that this procedure carries risks, including infection, allergic reactions, scarring, inconsistent color, and pigment spreading or fading. The final color may vary based on my skin tone.

    • I accept the permanence of this procedure and acknowledge that it is an art, not a science.

  • Eyebrows & Lip Procedures:

    • Procedures like Microshading, Ombre, Powder Brows, and Lip Blush typically require a healing period of 4-6 weeks, with a follow-up visit often needed.

    • During healing, side effects such as redness, swelling, scabbing, irritation, and minor bleeding may occur.

    • Pigments may fade after the initial procedure, and results are not guaranteed. Final color and shade appear after 6-8 weeks and may change over time.

    • Results can be affected by medication, skin type, smoking, alcohol use, cosmetic products, sweating, and other factors.

    • Correction of previous permanent makeup involves additional risks due to unknown factors like pigment brand, color, and depth. I accept full responsibility for the outcome.

  • Medical Conditions:

    • Doctor’s consent is required if I have: Diabetes, HIV, hepatitis, high blood pressure, thyroid disease, hemophilia, leukemia, anemia, skin cancer, pregnancy, nursing, or liver disorders.

  • Procedure Details:

    • Lip Neutralization may require 2-5 sessions, with 6-8 week intervals between sessions. Hypo- and hyperpigmentation are rare but possible. Pigment retention varies based on individual immune systems.

    • Periodic touch-ups are needed to maintain results, typically every 1-2 years.

    • I will wait until the procedure is fully healed (at least one month) before getting eyelash extensions or resuming lash growth serum.

  • Eyeliner Consent:

    • I will follow only my provider’s recommendations and release them from liability if I seek advice from third parties or get additional treatments elsewhere.

    • Swelling may occur the day after the procedure, which is normal.

  • Lip Blush Consent:

    • I understand the color will appear dark and vibrant immediately after the procedure, and I may need additional touch-ups for desired results.

    • I may experience cold sore breakouts or other complications, even if I’ve never had cold sores before. If complications persist for more than a month, I will seek medical advice.

    • I will keep the area clean and moisturized with the recommended aftercare ointment.

  • Photography:

    • I consent to Before and After photos of the treated area.

  • I certify that I have read and understood this consent form and will not hold Serene Reflections ( Zhanna Zakharova)  responsible for any unforeseen conditions arising from the procedure.

By signing this agreement, I acknowledge that I have read, understood, and agree to all the terms above.

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