Existing Client Consent Form

First Name *

Last Name *

Are you pregnant or nursing? *

Have you had Botox, filler or any type of chemicals/laser in the past 30 days (prior to our appointment)? *

Do you have excessive oily skin and/or large pores? *

Do you have a history of keloid scars? *

Are you a diabetic? *

Do you have cancer or are you currently undergoing radiation or chemotherapy? *

Do you have hemophilia or another type of bleeding disorder? *

Do you have hepatitis, HIV, or any other transmittable blood disease? *

Do you have a pacemaker and/or heart problem?

Do you have an auto immune disorder? *

Are you required to premed before dental procedures? *

Are you on any type of blood thinner? *

Have you used Accutane within the last year? *

Do you use retinoids or exfoliating products such as Retin-A, glycol or alpha hydroxy acid? *

FOR LIPS ONLY - Do you get cold sores?

FOR EYELINER ONLY - Do you wear contacts?

Have you had any Alcohol, Ibuprofen, aspirin, Vitamin E or fish oil in the past 7 days? *

Do you have any known allergies to medicines that end in “Caine” (lidocaine, microcaine etc), metals, latex, cosmetic products or anything else? *

If so, what are your allergies?

Do you have any skin conditions such as psoriasis, eczema, dermatitis, rosacea, acne, etc.? *

Please list any active medical conditions not previously mentioned. If none, type “N/A”: *

Please list any medications you are taking- both prescription and over the counter. If none, type “N/A”: *

CANCELLATION POLICY

No shows will be subject to a charge of the service price. Appointments not canceled or rescheduled within 24 hours of the appointment time or clients more than 15 minutes late will be subject to a $50 charge (and maybe asked to reschedule their appointment). By booking your appointment with Enhanced Beauty Bar, you acknowledge that you agree to this policy, and will pay late/cancellation fees.

RESCHEDULING

We asked that you please reschedule your appointment at least 48 hours in advance. Rescheduled appointments are based on current availability.

TOUCH UP POLICY

By making an appointment for an initial service with Enhanced Beauty Bar, you are agreeing to return for the 6 to 8 week touch up. This appointment is crucial to ensure the best results of your new brows. The cost of the 6 to 8 week touchup, your second visit, is an additional cost from the initial service for brows.

Please read all the sentences and sign the agreement.

I authorized Enhanced Beauty Bar to perform a cosmetic enhancement.
I understand that I may be required to provide a doctors note if I have certain medical conditions. This will be decided by Enhanced Beauty Bar.

I was informed that permanent and semi-permanent cosmetic enhancement is the same as the process of tattoo and is not an exact science, but an art. Results will vary from client to client and artist to artist.
I completely understand that in some rare cases, allergic reactions may occur even after my disclosure of all known allergy history I may have due to the pigment. I accept all the responsibility, and I fully understand the health risk of it.
I accept that the pigment might fade before or after 3 years, and may leave a mark or residue of color.
I understand that permanent make up has known and unknown complications and consequences including but not limited to: slight discomfort associated with the procedure, infection, scarring, inconsistent color, spreading, fanning, migration, or fading of pigments, temporary bleeding, bruising, swelling, puffiness and redness.

FOR LIP BLUSHING: I understand that I must premedicate with an antiviral such as Valtrex, if I am prone to getting cold sores. It is not possible to guarantee that fever blisters or cold sores will appear following lip procedures. An antiviral will drastically minimize the changes of this.

I understand the possible side effects of the procedure and will be able to diagnose if it is normal or not.
I confirm that I do not have any physical, medical, and mental conditions that might get conflict with the procedure.
I confirm that I will strictly follow the pre and post-procedure instructions given to me.
I understand that the 6 to 8 week touchup is required and will be an additional fee (for initial services only).
I confirm that all information I entered in this form is accurate and true to the best of my knowledge.
Enhanced practitioners will take pictures to capture my transformation. I consent to the use of my photos for marketing purposes. Please let us know if you do not consent

I hereby certify and give Enhanced Beauty Bar my full consent to perform the procedure. By signing below, I confirm that I have read and understand the policies and consent statements above.

Does Enhanced Beauty Bar have your consent to use the before/after pictures and videos for promotional and educational purposes? *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Date

Signature

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