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MARCH
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4100 – Safe Body Art
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PR0548695
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COMPLIANCE INFO
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Last modified
2/7/2024 9:41:30 AM
Creation date
10/17/2023 9:55:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0548695
PE
4120
FACILITY_ID
FA0027870
FACILITY_NAME
CHANGES BEAUTE LOUNGE (BARBER, NICOLE)
STREET_NUMBER
211
Direction
E
STREET_NAME
MARCH
STREET_TYPE
LN
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
211 E MARCH LN
P_LOCATION
01
QC Status
Approved
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SJGOV\cfield
Tags
EHD - Public
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Permanent Makeup A!A <br /> PERMANENT MAKEUP PRE-PROCEDURE INFO/ADVICE CONTINUED <br /> Please read the following information carefully and sign at the end: <br /> What To Expect On The Day of Procedure: <br /> Microblading/PMU Brows Procedure-When you arrive at your appointment,a brow map will be customized by a <br /> series of horizontal, vertical, and diagonal lines, based on your skin's proportions and drawn on with an oil-based <br /> crayon,thus,framing the area within which hair-like strokes,shading,and/or a combination of both will be micro- <br /> pigmented/tattooed into the dermis of the skin.(See for For Either Procedure) <br /> Permanent Eyeliner Procedure - Please arrive at your appointment without ANY eye makeup/cosmetics <br /> INCLUDING LASH EXTENSIONS.A thick layer of numbing cream will be applied and allowed to penetrated and take <br /> effect for 20-30 minutes.After the anesthetic is carefully removed,a map will be pre-drawn with an oil-based crayon, <br /> demonstrating the area that will be micropigmented/tattooed into the dermis of the skin. (See for For Either <br /> Procedure) <br /> •As a reminder:Although not very common,topical lidocaine used during the procedure can cause temporary pupil <br /> dilation especially in clients with lighter-colored eyes. This results in blurriness of vision for a few to several hours <br /> following the procedure.For this reason,we urge all clients as a precaution to plan for another person to drive them <br /> home. You will be asked to sign and initial that you have a backup ride from the spa in the case of said <br /> dilation/blurriness of vision,if necessary,on the day of the procedure before lidocaine is applied. <br /> PMU Lip Blushing/ Lip Liner Procedure-When you arrive at your appointment,a topical numbing agent will be <br /> applied to your lips for thirty minutes to help with sensitivity during the procedure.During this time we will do a mini <br /> consultation with you to discuss your desired shade of lip colour,your ideal lip shape and as well as do sketches that <br /> need your approval.During the procedure the numing agent will be continuously apllied to the lips throughout the <br /> appointment to ensure comfort.After that we will insert a natural-looking pigment into your lips using small needles. <br /> This is done in multiple layers to help create an even tone.The process can take between 1 and 3 hours. <br /> For EITHER PROCEDURE-Before any tattooing occurs,you will sign off on said map/pre-draw along with the color of <br /> pigment demonstrated by its application to the forehead.After signing,the micropigmentation procedure will begin, <br /> one side at a time, using a rotary pen, equipped with a sterilized, disposable needle cartridge(s). Between passes - <br /> starting after the first - a numbing solution of lidocaine will be applied to add to comfort level. The products are <br /> formulated to be perfectly safe and can be purchased over the counter from most pharmacy/chemist.As a result of the <br /> treatment,combined with the use of the anesthetic,you can expect to experience some redness/swelling that can last I- <br /> 4 days.Pigment will be wiped throughout the procedure,and your technician will keep you informed on the progress. <br /> Before and after photos will be taken if/when photo release is signed. You must always follow your post procedure <br /> advice and after care for the best results. <br /> I have read and fully understood the above information regarding the process of the procedure to be <br /> received.If receiving permanent eyeliner/lash enhancement,I understand the topical anesthetic risks may <br /> include possible pupil dilation and subsequent blurriness of vision to follow,and therefore,I agree to plan for <br /> an alternative ride from the spa following the procedure. <br /> Client Name/Signature Date <br /> Artist Name/Signature Date <br />
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