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I, am over the age of 18,1 am not under the influence of drugs or <br />alcohol. I'm not pregnant or breastfeeding. I have been fully explained the general nature of semi-permanent <br />makeup / microblading / shading procedure. <br />I hereby consent to being a client of Luxe Beauty Loft. and to receive treatment by Leticia Harris for the purpose of <br />executing the procedure known as SHADING/POWDER/SIGNATURE BROWS. X <br />Number of required visits: 2 <br />I agree to waive and release to the fullest extent permitted by law Leticia Harris/Luxe Beauty Loft from all liability for <br />any and all claims or causes of action that I, my estate, heirs, executors or assignees may have for personal injury or <br />otherwise, including any direct, indirect, and/or consequential damages, whatever the nature, which may result or <br />arise from application of my semi-permanent makeup application whether caused by the negligence or fault of Leticia <br />Harris or others otherwise associated with Luxe Beauty Loft X <br />I understand that the semi-permanent skin pigmentation procedure carries with it the possibility of complications and <br />consequences associated with this type of cosmetic procedure, including but not limited to: <br />Infection, allergic reaction, scarring, inconsistent color, spreading, fanning or fading of pigments. I also fully <br />understand the possibility of other complications or consequences not related or indicated within this Client Consent <br />Application form. X <br />I understand the actual color of the pigments may be modified slightly due to the tone and color of my skin. The artist <br />has given me Verbal and Written POST Procedure Instructions on the care of my semi-permanent makeup application <br />while it's healing, and I acknowledge that it is possible that the permanent makeup application can become infected; <br />particularly if I do not follow the instructions given to me. X <br />I agree to contact leticia Harris, if there are signs of infection, including but not limited to redness, swelling, extreme <br />tenderness of the procedure site. If any touchup is needed due to my own negligence, I agree that the work will be <br />done at my own expense. X <br />I understand that over time, the colors and the clarity of my semi-permanent makeup will fade due to unprotected <br />exposure to the sun and naturally occurring dispersion of pigment under the skin. The application of permanent <br />makeup is likely to result in a permanent change to my appearance and can only be removed by laser or surgical <br />means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin to <br />its exact appearance before being tattooed. X <br />I fully understand this is an artistic tattoo process that Leticia Harris was taught & learned as such. Therefore, it is not a <br />science but a learned art form, purely artistic in its nature. I request the semi-permanent skin pigmentation <br />procedure(s), and fully accept the semi or full permanence of the procedure as well as the possible complications and <br />consequences of Shading. X <br />I fully understand that Inks are not FDA approved and health consequences are unknown. X_ <br />