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Permanent Makeup Auk Procedure Informed Form FULL NAME D.O.B. PHONE# ADDRESS Please read these statements carefully: Permanent cosmetics are a form of tattooing also called Micropigmentation. • Re-touch procedures are nearly always required following the initial procedure;please note this is a two stage treatment process,retention holds much stronger following the retouch. • A minimum healing period of four/six weeks is required before a re-touch procedure can be performed depending on age and skin type. • A healed result can be seen 4-6 weeks after the treatment. • Retention of pigment depends on many factors including,skin type,age of client,adhering to aftercare procedure,lifestyle,sun exposure,medication and vitamins. • On rare occasions the pigment may migrate under the skin particularly if very oily based skin type or open pours.Therefore the treatment will give a more`powdered'look and may have less retention. • Old Scaring may act like'dead skin'for the ink and often times do not hold pigment. • Application of permanent cosmetics can be painful. • The pigments will fade over time which may vary with each client. • Immediately after the procedure,the pigment can be 30 to 50%darker than the desired result. • There may be immediate or delayed allergic reaction to pigments. However, allergic reactions are extremely rare. •A negative allergy test result will not guarantee that you will not have an allergic reaction. •Allergic reactions to anaesthetics can occur. • Permanent cosmetics cannot be applied to pregnant women or nursing mothers. • Permanent cosmetics cannot be applied to any person under the age of eighteen. • Infections can occur if aftercare instructions are not followed correctly. • There may be swelling and redness following the procedure. •You may experience minor bleeding. • It is recommended that clients receiving treatment for eyeliner should have someone drive them home. • Corneal abrasion may occur during eyeliner procedures.However,corneal abrasion is rare. • Clients receiving lip procedures who have had previous problems with cold sores/herpes may have an outbreak following the procedure.Anti herpes medication is available over the counter or on prescription and has been shown to prevent or minimize such outbreaks. • Lip procedures may appear dry and flaky for up to one week following the procedure. • If you have an MRI scan within 3 months of your permanent cosmetics procedure we recommend that you discuss this with your doctor. • Possible scarring,inconsistency of colour and loss of eyelashes may occur. • It is normal for the top layer to flake off,DO NOT PICK,as you will rip off the deeper layers of pigment with it and it will have no retention.