BROWS BY OUIDA

Consent and Release Agreement for Microblading

AKA 3D Eyebrow Embroidery 

This form is designed to give information needed to make an informed choice of whether or not to undergo a “Microblading/3D Eyebrow Embroidery Semi-­‐Permanent” application. If you have questions, please don‘t hesitate to ask.  

Although Microblading/3D Eyebrow Embroidery is affective in most cases, no guarantee can be made that a specific client will benefit from the procedure.  

Microblading/3D Eyebrow Embroidery 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 stickily 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 the healing is completed.  

Initially the color will appear much more vibrant or darker compared to the end result. Usually within 5 -------7 days the color will fade 40-­‐50%, soften and look more natural. The pigment is semi-­‐permanent and will fade over time and will likely need to be touched-­‐up within 6 months to 2 years.  

Photography Release Consent  

We would like your permission to use these photos for advertising. Your consent is necessary regarding this. Please circle and indicate with your signature if you would like your photos used or not used in advertising.  

YES, feel free to use them   NO, please do not use them  

 

I have read, understand and agree to the above instructions.

 

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Print Name                                         Signature                                                     Date

 

Special requests, concerns or remarks for technician:  __________________________

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