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D z O <br /> X 0 l. <br /> 1 O rt n v <br /> Q JrD <br /> CD W D fD <br /> Ln <br /> n O O <br /> r <br /> N o �' D o <br /> m C p <br /> _ 7 <br /> aj <br /> Versailles aj <br /> 1010 Central Salan And Spa o <br /> Ave* Tra �_ n <br /> 1,�1 CA 95376• '< <br /> Salon 209 835 I505 CA 209 275-4133 D alized so Post Procedure Instructions <br /> FOR MICROBLADIIVG E 0 ID <br /> YE11R to <br /> ti1e r OW PROCEDURES 1S W P For 74 da s followin a (D p1 <br /> Ifcationof rmanentrosmettcs: J <br /> APP1Y A&D <br /> ointment <br /> s rin l Five t rues fingertips. In- a day for five days following the procedure,using a clean cotton swab:not your rt <br /> Do not rub of pick at the lu <br /> Food a P e epithelial crust?allow it to flake off on its own.There should be absolutely no scrubbing,no cleansing T.s creams or chemicals.Do not expose treated area to full pressure of the water in the shower. rD <br /> { Do not soak treated area in bath,swimming pool or hot tub,Do notswim in fresh,salt or Chlorinated pool water. <br /> Do not expose the treated area to the sun. 75 <br /> and sir Use a total sun block after the procedure area has healed to prevent future fading of pigment color. p <br /> proced + You cannot give blood for 1 year following your procedure(per American Red CYCII - <br /> Use sterile bandages and dressings when necessary. 0 <br /> Please <br /> A_ILIP Generally,fresh permanent makeup will exhibit some swelling,inflammation and discharge accompanied by a 5' <br /> to take pink color around the treated area.However,if it starts to look bright pink to red and feels warmer than the O <br /> ialld p rest of the skin for more than three days or if the swelling becomespainful or pain radiates beyond the treated <br /> area or if the discharge doesn't stop after 48 hours or produces yellow or green pus,or if you see red streaks v <br /> °take going from the procedure toward the heart;then seek medical attention as you may have an infection or other <br /> ha medical problem. 00 <br /> E1 I understand that at the first sign of an infection,adverse reaction or allergic reaction to the procedure,I must 0 <br /> notify Permanent Choices,a health care practitioner and the California Department of Health,Drugs and iscr, <br /> Medical Devices Division(916)558-1784. cD <br /> Failure to follow post-treatment instructions may cause loss of pignent,discoloration or infection. Z <br /> dd r Remember,colors appear brighter and more sharply defined immediately following the procedure. As the pq <br /> healing progresses,color will soften. A touch-up procedure may or may not be necessary. Final results cannot O <br /> e; l be determined unfit healing is complete.Complimentary touch-up procedures must be made between fa$ 0 <br /> A weeks following the initial procedure.An additional fee of$50+will apply for touch-ups after 8 weeks 70 <br /> following the initial procedure. rD <br /> rt <br /> rD <br /> P Enjoy your permanent cosmetics t? <br /> r Photocopy Driver's License Here <br /> of t f 1 L/y y 9 Or Record Necessary Information <br /> I Signature Name: <br /> License Number: <br /> disc! State: <br /> Date of Birth: <br /> 'dent Age: <br /> \Usrn l y <br /> C:\Usen\Vrrsallles 2\I?esioop\2l)17 RMSED Consent Form FEMPLATE ERICA,doca Rev:12/9/2916 Page 6 of a <br /> O <br /> ,8 n, � <br /> N <br /> N <br /> J <br />