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CONSIOW"11' FORM FOR T CCWETICS "U � u and consent to the application of permanent color and consent to have the following procedures performed by: PI a r t n hfollowing tl3gt mayi u: Eyeliner Eyebrows Lip liner Full lip color Scar camouflage Beauty mask Areola repigmentation Other Plea r d and N e€ to nen I understand that the process used to apply color is not a one-step process and requires su_bsequent visits to achieve desired results. T further understand the fee indudes my first visit and ONE perfecting visit. Maintenance touch-ups are scheduled as needed and may vary from six months to three years. Fees for maintenance visits, pigment replacements, and scar camouflage are based on any hourly fee. I understand that with time, pigment can (and will) fade and change color according to metabolism, skin type, medications, age, smoking, alcohol, sun exposure, Retin-A, and Glycolic acids. ® I acknowledge that no guarantees have been made to me concerning the results of this procedure and that the professional recommendation is a NATURAL LOOK. I understand the nature of the procedure and possible complications or adverse effects that may occur as a result of applied pigments. I fully understand this is a tattooing pr ; therefore it is NOT considered a science, but an art*. n 9-0c,Q.S S - I have received and acknowledged - and post- procedure instructions, and agree to strictly adhere to such instructions. I accept responsibility for determining the color, shape, and position of the pigments that will be applied. I understand the actual color of the pigment may be modified slightly due to the tone&color of my skin. I understaind that the taking of before an aft ph raphe of procedures are required. my-' Wz not FDR The knovv possible complications from micropig entation are: redness,swelling, bruising, dry patches, and tenderness. it Is normal to lose approximately 1/3 of the color during the healing process. After most procedures, the color may appear to be a shade too dark; in 6 days, it may appear to be too light. After 10 days, the valor will show more initially. It will appear softer when completely healed, as the color will come from the dermal layer of the skin to the epidermal layer of the skin. In the event of a CAT son or an MRI, please inform your physician of your Iron Oxide Permanent Cosmetics, as some pulling or burning sensation may o=r during the procedure. Other risk factors for bloodbome,,gghogens Client's gionature: Date;