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Inform its now. •Allergic Reaictleer:There is a possibility of an allergic reaction to the pigments or other materials used.You may take a 5-7 day patch test to determine this.Plea initial to: Waive____or Take___ The alternative to these possibilities is to use cosmetics and not undergo the microbtading procedure. CAmsest for MicroMading Procedure: Please read and Initial all OWL ------ I am currently not under the influence of any drugs or alcohol. ------ I am a years or older and have provided a valid dopy of troy Driver licence. ------ I am not pregnant or nursing. ------ I do not currently nor have I taken Accutane within the last 12 months. I have not had Botox and/or other cosmetic filler procedures within the past 2 wrelm I have not had surgery of any kind within the past six months. ------ I have not taken any blood thinning medication with the past 72 hours nor have I taken aspirin/ibuprofen within the past 24 hours. Aftercare instructions have been explained to me and are attached to this consent form. A written copy will be given to me to retain in my possession,which I will follow to the best of my ability.If I have questions 1 will call or email my technician. I understand that a certain amount of discomfort is associated with this procedure and that swelling,redness and bruising may occur. I understand that Retin A.Renova.Alpha hydroxy and Glycolic Acids must not be used on the treated areas.They will alter the color. I understand that sun,tanning beds,pools.some skin care products and medications can affect my permanent makeup. ------ I accept the responsibility for explaining/approving my desire for specific colors, shape,and position for the microblading procedure done today. I understand that implanted pigment color can change or fade over time due to circumstances beyond the technicians control and I will need to maintain the color with future applications and a touch-up session within 6-8 weeks.