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Bridal Makeup Service Contract
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Ombre Brow Consent Form
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Lash Extension Consent Form
LIP BLUSH
Lip Blush Aftercare
Lip Blush Consent Form
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Brow Tattoo Consent Form
First name
*
Last name
*
Email
*
Phone
Birthday
Día
Mes
Mes
Año
Address
Have you had any of the following?
*
Hair loss
HIV
Healing problems
Prolonged bleeding
Cancer
Low blood pressure
Liver decease
Sensitivity to cosmetics
Anemia
Diabetes
High blood pressure
Hepatitis
Keloids
Birthmarks or moles on the brow area
NONE
Have you had an allergic reaction to the following?
*
Latex
Lanolin
Vaseline
Lidocaine
Paints
Hair dyes
Medication
Metals
Crayons
Glycerin
NONE
Are you currently taking medications that thin the blood?
*
Yes
No
List any medications you have been taking in the past 6 months
Have you received chemotherapy or radiation in the past year?
*
Yes
No
Are you currently pregnant or breastfeeding?
*
Yes
No
Do you bruise or bleed easily?
*
Yes
No
Do you scar easily?
*
Yes
No
Chemical or laser peel within 6 weeks?
*
Yes
No
What are the main concerns relating your eyebrows and what you would like to improve?
Client's Consent
*
I have read all the procedure information and after care instructions.
I have fully understood all the information in this form.
I can confirm that all the information provided by me is correct and truthful.
I confirm that I am 18 or older
I hereby consent and authorize Dariana Torres to take pictures and videos for educational purposes and to post on social media.
*
Yes
No
Date picker
*
Signature
*
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