COMPLIANCE INFO - Laserfiche WebLink

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I am aware that the result of the procedure is determined by the following: Skin Characteristics - i.e. dry/oily/sun damaged, natural skin undertones, alcohol intake and smoking, a compromised immune system, post procedure care treatment. I understand that implanted pigments can turn colour or fade over time due to circumstances beyond the control of Permablend Pigments, Ever After Pigments, Evenflo Pigments, World Famous Ink, Eternal Ink or Doreme Pigments. I understand that I will need to maintain the colour with futureapplications. I have been advised that upon completion of the procedure there may be swelling and redness of the skin, which will subside within 1-4 days depending on lifestyle. In some cases, bruising can occur. I have been advised that I can resume normal activities immediately following the procedure however, using cosmetics, prolonged exposure to water, excessive perspiration and exposure to the sun should be limited for up to 2 weeks following the infusion process. I understand that immediately after the procedure the enhancement can be 50% darker than the desired result and can take between 4-10 days to lighten. I understand that the true colour will be visible 6-8 weeks after each application, and that the colour may vary according to skin tones, skin type, age and skin conditions. I appreciate that some skins accept colour more readily than others and no guarantee of an exact effect or colour can be given. I am aware that if I have had a previous outbreak of cold sores/herpes and receive a lip enhancement I may have an outbreak again following the procedure. I have been made aware that anti-herpes medication is available over the counter or on prescription and has been shown to prevent or minimize such outbreaks. I understand that it is MY responsibility to obtain a prescription from a doctor for fever blister medication to help an outbreak. I am aware that if I have had a previous eye disorder or eye infection and receive an eyelash enhancement, the disorder may reoccur again. I agree to use the correct medication to prevent such a disorder from recurring. I am aware that even though my vision is not affected by permanent cosmetic eye enhancements, I may wish to have someone drive me home. I understand that I may experience dry lips for up to 2 weeks following permanent cosmetic lip. If I am also a tobacco user, I understand that the healing process may be negatively affected and I may have difficulty with colour retention. I understand that I must wait one full year following any tattoo/PMU procedure before donating blood, per Red Cross guidelines. I agree to inform my doctor of my permanent cosmetic enhancement if I require an MRI scan within a 3-month period of receiving the procedure. I agree to follow all pre-procedure instructions as provided and explained to me by the practitioner. I understand that infection and possible scarring can occur if I do not adhere to the said instructions. To my knowledge I do not have any physical, mental or medical impairment or disability that might affect my well being as a direct or indirect result of my decision to have the procedure done at this time. I am at least 18 years old. I am not under the influence of drugs or alcohol. CONTRAINDICATIONS • Hemophilia (bleeder's disease) yes❑ no❑ • Diabetes 11 yes❑ no❑ • HepatitisA.B.C.D.E.F yes❑ no❑