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First Name Last Please read and check each box: Phone Number () I am 18 years of age or older Permanent Nature of Lip Blush: a semi-permanen tattoo that can enhance the color and shape of your lips and glue the impression of more fullness. This is done by depos Ing color ink Into your lips and along your lip line to improve the overall look. The color is subtle to give natural -looking res Its. This ink is permanent but has to be touched up every 2-3 years.) *Inks used for Lip Blush procedure are not FOA Apt Possible Risks/HazardsJComplicatlons: PAIN: There could be pain even after the topical an< others. INFECTIONS: Infection is very unusual. Less I must be kept clean and only touched with freshly cl PIGMENT: This can be a result of poor healing, infer correct any uneven appearances. ASYMMETRY: Eve and adjustments may be needed during the follow Some people bruise and swell more than others. Ice first few days. ANESTHESIA: Topical anesthetics are Benzocaine, Tetracaine Epinephrine in a cream or g your technician immediately. MRI: Pigments used it may be required if you need to be scanned by an M cosmetics. ALLERGIC REACTION: There is a small po. determine this Llp Specific Cautions: " Herpes Simplex Virus: If you have an outbreak, you lust weeks. If you have a history of cold sores, please as treatment and 5 days after. Lip blushing can trigger Mediterranean, Asian, and Latin skin types. Undersi treated very carefully. Chapped Lips: Please follow i and hydrate. The lips must be a clean canvas for goy before lip blushing procedure. Yes, I have read and understand the possible sthetic has been used. Anesthetics work better on some people than tan 0.25% of the population has an allergic reaction. The areas treated paned hands. See "After Carefor Lip Blush" for instructions. UNEVEN :Ion, bleeding, or other causes. Your follow up appointment will likely y effort will be made to avoid asymmetry, but our faces are asymmetrical, p session to correct any unevenness. EXCESSIVE SWELLING/BRUISING: packs may help the brulsing and swelling. Ittypically disappears within the rsed for numbing the area to be tattooed. Lidocaine, Priloca!ne, .I form are typically used. If you are allergic to any of these please inform permanent cosmetic procedures contain inert oxides; a low-level magnet tl machine. You must inform yourtechnician of any tattoos or permanent sib and health consequences are unknown ility of an allergic reaction. You may take a 5 -7 -day patch test to reschedule your appointment and wait until it has healed at least 6 your doctor for an antiviral medication, and take them 5days before old sores! Hyperpigmentation: Most seen in African, Caribbean, nd that the risk of the procedure may cause hyperpigmentation but will be e Pre -Care Instructions to exfoliate 1 week for everyday until appointment I pigment retention and healing. Lip Fillers: Must wait a weeks after fillers hazards and complications. I understand that a certain amount of discom ort is associated with this procedure and that swelling, redness and bruising may occur. I understand that sun, tanning beds, pools, so ne skin care products and medications can affect my permanent makeup. r; I understand that implanted pigment color m iy slightly change or fade overtime due to circumstances beyond control and that I will need to maintain the color with futur applications and a touch up session within 60 days. I am 18 years of age or older Permanent Nature of Lip Blush: a semi-permanen tattoo that can enhance the color and shape of your lips and glue the impression of more fullness. This is done by depos Ing color ink Into your lips and along your lip line to improve the overall look. The color is subtle to give natural -looking res Its. This ink is permanent but has to be touched up every 2-3 years.) *Inks used for Lip Blush procedure are not FOA Apt Possible Risks/HazardsJComplicatlons: PAIN: There could be pain even after the topical an< others. INFECTIONS: Infection is very unusual. Less I must be kept clean and only touched with freshly cl PIGMENT: This can be a result of poor healing, infer correct any uneven appearances. ASYMMETRY: Eve and adjustments may be needed during the follow Some people bruise and swell more than others. Ice first few days. ANESTHESIA: Topical anesthetics are Benzocaine, Tetracaine Epinephrine in a cream or g your technician immediately. MRI: Pigments used it may be required if you need to be scanned by an M cosmetics. ALLERGIC REACTION: There is a small po. determine this Llp Specific Cautions: " Herpes Simplex Virus: If you have an outbreak, you lust weeks. If you have a history of cold sores, please as treatment and 5 days after. Lip blushing can trigger Mediterranean, Asian, and Latin skin types. Undersi treated very carefully. Chapped Lips: Please follow i and hydrate. The lips must be a clean canvas for goy before lip blushing procedure. Yes, I have read and understand the possible sthetic has been used. Anesthetics work better on some people than tan 0.25% of the population has an allergic reaction. The areas treated paned hands. See "After Carefor Lip Blush" for instructions. UNEVEN :Ion, bleeding, or other causes. Your follow up appointment will likely y effort will be made to avoid asymmetry, but our faces are asymmetrical, p session to correct any unevenness. EXCESSIVE SWELLING/BRUISING: packs may help the brulsing and swelling. Ittypically disappears within the rsed for numbing the area to be tattooed. Lidocaine, Priloca!ne, .I form are typically used. If you are allergic to any of these please inform permanent cosmetic procedures contain inert oxides; a low-level magnet tl machine. You must inform yourtechnician of any tattoos or permanent sib and health consequences are unknown ility of an allergic reaction. You may take a 5 -7 -day patch test to reschedule your appointment and wait until it has healed at least 6 your doctor for an antiviral medication, and take them 5days before old sores! Hyperpigmentation: Most seen in African, Caribbean, nd that the risk of the procedure may cause hyperpigmentation but will be e Pre -Care Instructions to exfoliate 1 week for everyday until appointment I pigment retention and healing. Lip Fillers: Must wait a weeks after fillers hazards and complications.