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Permanent Makeup Informed Consent Form I, . am over the age of 18, am not under the influence of drugs or alcohol,am not pregnant or nursing and desire to receive the indicated permanent pigmentation procedure. The general nature of cosmetic micro-pigmentation,as well as the specific procedure to be performed,has been explained to me. I hereby authorise perform upon myself the following procedure(s) If any unforeseen condition arises in the course of this procedure(s),calling in her judgement in addition to,or different from those now contemplated,I further request and authorise her to do whatever she seems advisable and necessary in the circumstances. I accept responsibility for determining the colour, shape and position of the permanent cosmetic procedure as agreed during the course of my consultation. I understand that an allergy test does not guarantee that I will not have an allergic reaction to the pigment. We cannot accept responsibility if the treatment area does not numb. Each individual is different according to the skin type. For all procedures a cream or gel topical anaesthetic is used. These products are perfectly safe, and can be purchased over the counter from any chemist. I fully understand and accept that non-toxic pigments are used during the procedure and that the cosmetic enhancement achieved may fade over a period of 1-3 years.Even though the colour has faded the pigment will stay in the skin indefinitely. For eyeliner procedures you will be asked to keep your eyes closed throughout the numbing period. If for some reason the anaesthetic gets into the eye,you must advise your technician at once. It is not harmful to the eye although you will experience some stinging and slight discomfort.The cream will be removed and your eyes will be immediately flushed with a sterile saline solution. It is then safe for the technician to reapply the anaesthetic. NOTE: If you experience stinging in the eyes and do not inform your technician immediately,the anaesthetic may numb the eyeball,and a possible corneal abrasion may occur.This can result in a temporary streaming and light sensitivity of the eyes.You may be unable to open your eyes and each time you blink it may be painful,and temporary blurry vision may occur.Corneal abrasion,however, is rare. I have been informed that the highest standards of hygiene are met and that sterile disposable needles and pigment containers are used for each individual client,procedure and visit. I understand and accept that each procedure is a process requiring multiple applications of pigment to achieve desirable results, and that 100% success cannot be guaranteed during the first procedure.I understand that this is why I will need to return for a retouch procedure.