Client Consent Form | Kaymac Beauty

First Name

Last Name

Email

Phone

I acknowledge that I have been given the full opportunity to ask any questions which I might have. I also acknowledge that all my questions have been answered to my full satisfaction. I specifically acknowledge that I have been advised of the fact of the matters set below, and I agree as follows:
(Check all that apply)

I acknowledge that it is not reasonably possible to determine whether I might have an allergic reaction to any of the pigments, topical preparations, or processes in the procedure; and I agree to accept the risk that such a reaction is possible. I have informed the practitioner of any existing problems

I acknowledge that complications are always possible as a result of the Permanent Makeup procedure, particularly in an event where post-procedural instructions are not followed.

I realize that my body is unique and the practitioner cannot predict how my skin may react as a result of the procedure.

I acknowledge that the procedure will result in a temporarily permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove the result.

I understand that future laser treatments or other skin altering procedures may alter or degrade my Permanent Makeup. I further understand that such changes are not the fault of the practitioner. I further understand that such changes may not be correctable though further Permanent Makeup.

For the purpose of education or assistance, I consent to the admittance of authorized observers to the procedure.

I acknowledge that the obtaining of Permanent Makeup procedure is by my choice alone, and I consent to the application of the procedure and to its risks, and to any conduct or actions of the practitioner reasonably necessary to perform the procedure.

I acknowledge that I have been given the full opportunity to ask any questions which I might have. I also acknowledge that all my questions have been answered to my full satisfaction. I specifically acknowledge that I have been advised of the fact of the matters set below, and I agree as follows:
(Check all that apply)

I acknowledge that it is not reasonably possible to determine whether I might have an allergic reaction to any of the pigments, topical preparations, or processes in the procedure; and I agree to accept the risk that such a reaction is possible. I have informed the practitioner of any existing problems.

I acknowledge that complications are always possible as a result of the Permanent Makeup procedure, particularly in an event where post-procedural instructions are not followed.

I realize that my body is unique and the practitioner cannot predict how my skin may react as a result of the procedure.

I acknowledge that the procedure will result in a temporarily permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove the result.

I understand that future laser treatments or other skin altering procedures may alter or degrade my Permanent Makeup. I further understand that such changes are not the fault of the practitioner. I further understand that such changes may not be correctable though further Permanent Makeup.

For the purpose of education or assistance, I consent to the admittance of authorized observers to the procedure.

I acknowledge that the obtaining of Permanent Makeup procedure is by my choice alone, and I consent to the application of the procedure and to its risks, and to any conduct or actions of the practitioner reasonably necessary to perform he procedure.

Sign Your Name

Today's Date

Captcha

Please fill out the form below prior to your appointment at Kaymac Beauty.