Micropigmentation Consent - Velu-Beauty Brow and Wax

Micropigmentation Informed Consent - Form

Micropigmentation Informed Consent

Please provide your personal information.

First Name

Last Name

Date of Birth

Select Appointment Slot

Choose your preferred date and time for the micropigmentation procedure.

Appointment Date

Preferred Time Slot

Important Notice: I understand that there may be discomfort associated with the procedure and that possible adverse effects may include minor bleeding, bruising, redness, swelling, pigment fading, or pigment loss. Secondary infection is uncommon but can occur if aftercare instructions are not followed. Please initial each statement below to confirm you have read and understood it.

I have informed the practitioner of all known allergies. I understand an allergic reaction to pigments, dyes, or topical products is still possible.

I understand complications may occur if post-procedure instructions are not followed, and I accept responsibility for poor healing caused by non-compliance.

I understand every skin type heals differently, and Royal Beauty European School cannot predict exact healed results or retention.

If I have had previous micropigmentation or tattooing by another provider in the same area, I understand there are additional risks due to unknown pigment history, composition, or colour changes.

Previous work in this area:

YES

I understand additional appointments beyond the included follow-up, if needed, may be charged at the school’s standard rates.

I understand no guarantee has been made that the final results will appear exactly as I desire.

I understand the procedure may create a long-lasting change in my appearance and that removal or alteration may be difficult, limited, or impossible.

I understand future skin procedures, laser treatments, surgery, fillers, or Botox may alter or degrade the appearance of my micropigmentation.

I understand these changes are not the fault of Royal Beauty European School or its employees/contractors and may not be fully correctable.

10.

I confirm that obtaining semi-permanent makeup is my personal choice and I consent to the procedure and the actions reasonably necessary to perform it.

11.

I will be given the opportunity to approve the design and pigment colour before the procedure begins.

12.

I consent to relevant before-and-after photographs being taken for internal client record purposes.

13.

Optional marketing photo consent: Royal Beauty European School may use before-and-after photos only if I separately authorize it.

14.

I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.

15.

I understand the complimentary retouch, if included, must be completed within 2 months of the initial procedure unless otherwise stated.

16.

I understand that trauma, irritation, or sun exposure during healing may increase the risk of post-inflammatory hyperpigmentation in sensitive skin types.

17.

If I have a history of cold sores / herpes simplex, I understand a recurrence may be triggered after lip blushing, sometimes around the 4th day after the procedure. I may consult my physician about preventive antiviral medication if appropriate.

I have read and understood the statements above. I acknowledge that I have received no warranties or guarantees regarding the benefits or results of the procedure and that I am capable of making this decision for myself.

Client Signature (Digital)

Date

Parent/Legal Guardian Signature (If under 18)

Parent/Guardian Signature Date

Office / Practitioner Use Only

Some description about this section

Practitioner Signature

Practitioner Signature Date