Terms and Consent forms

Your permission is necessary before commencing any treatments. The permission form is intended to be a tool to ensure that you have been informed about your procedure, the risks and benefits, and to provide you with a chance to ask questions.

I understand that the success of tattoo removal varies greatly depending on the age of the tattoo and the concentration of pigment colors. The number of treatments varies widely depending on who applied the tattoo (professional homemade). Most commonly, 2-12 treatments are necessary to remove the pigment. I understand that there is no guarantee that this procedure will remove all the pigment. Black, dark blue and blue are easier to remove. Green, orange, and yellow are more difficult to remove.

I understand that a shadow of the tattoo may be present after the treatments. I understand that my skin was originally scarred by the tattoo application needle or bleed. This injury may remain even if all the pigment is removed. I understand that my skin will be extremely sensitive to sunlight following the procedure. I agree to refrain from tanning for 2 weeks prior and 4 weeks following the treatment. Maximum SPF should be worn at all times.

I have read and understand this agreement and all my questions have been addressed and answered to my satisfaction. I consent to the terms of this agreement.

I undersigned, Tatooo Removal professional, hereby certify that I have reviewed the foregoing treatment consent with this patient (including the risks of and alternatives to treatment) on or prior to the first date of treatment and have given the patient the opportunity to ask questions regarding his or her treatment, including the opportunity to communicate with a physician.

Tattoo Removal Technician

I am over the age of 18, am not under the influence of drugs or alcohol, am not pregnant or nursing and desire to receive the indicated permanent cosmetic procedure. The general nature of cosmetic tattooing as well as the specific procedure to be performed has been explained to me.

Microblading, microshading, powder brows, PMU, I have been informed of the nature, risks, and possible complications and consequences of permanent skin pigmentation. I understand the permanent skin pigmentation procedure carries with known and unknown complications and consequences associated with this type of cosmetic procedure, including but not limited to: infection, scarring, inconsistent color, spreading, fanning or fading of pigments. Corneal abrasions are a rare side effect, especially if I rub or scratch my eyebrows or apply contacts too soon after the procedure.

I understand the actual color of the pigment may be modified slightly, due to the tone and color of my skin. I fully understand this is a tattoo process and therefore not an exact science, but an art. I request the permanent skin pigmentation microblading, microshading, powder brows, PMU, accept the permanence of the procedure as well as the possible complications and consequences of microblading and powderbrow. There is a possibility of an allergic reaction to pigments. A patch test is advisable however it does not ensure a client will not have an allergic reaction.

I consent and agree with these terms and conditions and I release the technician from liability if I develop an allergic reaction to the pigment. I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin-altering procedures, it may result in adverse changes to my permanent cosmetics. I acknowledge some of these potential adverse changes may not be correctable.

I have received pre- and post-procedure instructions and will strictly adhere to such instructions. I understand that my failure to do so may jeopardize my chances for a successful procedure. If I am on any medication for depression or any other mood-altering prescription, I will advise my technician. If I have ever had cold sores, I will consult with and strictly follow my doctor’s instructions before contemplating any permanent cosmetic procedure around my lips.

I understand that the taking of before and after photographs of microblading, microshading and powderbrows are a condition of such procedure(s) microblading, microshading and powderbrow.

I certify I have read and initialled the above paragraphs and have had explained to my understanding this consent and procedure permit. I agreed and accepted full responsibility for the decision to have this cosmetic PMU, microblading, microshading and powderbrow work done.

To the patient:

Being fully informed about your condition and treatment will help you make the decision whether or not to have a microneedling treatment. This disclosure is not to alarm you but to better inform you so that you may withhold your consent for this treatment.

Description of the Procedure:
Microneedling treatment allows for controlled induction of the skin’s self-repair mechanism by creating micro-“injuries” in the skin, which triggers new collagen synthesis, yet does not pose the risk of permanent scarring. The result is smoother, firmer and younger-looking skin. Microneedling procedures are performed in a safe and precise manner with the use of the sterile needle head. The procedure is normally completed within 1h-2h depending on the required treatment and anatomical site.

Side Effects:
After the procedure, the skin will be red and flushed in appearance in a similar way to moderate sunburn. You may also experience skin tightness and mild sensitivity to touch on the area being treated. This will diminish greatly after a few hours following treatments and within the next 24 hours the skin will be completely healed. After three days there is barely any evidence that the procedure has taken place.

Contraindications:
Microneedling treatment is contraindicated for patients with: keloid scars, scleroderma, collagen vascular diseases or cardiac abnormalities, a hemorrhagic disorder or haemostatic dysfunction, and active bacterial or fungal infection.

Precautions and Warnings:
Microneedling treatment has not been evaluated in the following patient populations, as such, precautions should be taken when determining whether to treat: scars and stretch marks less than one year old; women who are pregnant or nursing; keloid scars; patients with a history of eczema, psoriasis and other chronic conditions; patients with a history of actinic (solar) keratosis; patients with a history of herpes simplex infections; diabetics or patients with wound-healing deficiencies; patients on immunosuppressive therapy; and skin with presence of raised moles or warts or targeted area.

Patient Consent, I understand that results will vary among individuals. I understand that although I may see a change after my first treatment, I will likely require a series of sessions to obtain my desired outcome. The procedure and side effects have been explained to me including alternative methods, as well as the advantages and disadvantages. I am advised that though good results are expected, the possibility and nature of complications cannot be accurately anticipated and that, therefore, there can be no guarantee as expressed or implied either as to the success or other results of the treatment. I am aware that microneedling treatment is not permanent as natural degradation will occur over time.

I state that I have read (or it has been read to me) and I understand this consent and I understand the information contained in it. I have had the opportunity to ask any questions about the treatment including risks or alternatives and acknowledge that all my questions about the procedure have been answered in a satisfactory manner. I verify that I have read and understand the above statements and agree to them.

I agree to have Beauty by Nuch (Naruenuch) apply, retouch, and/or remove individual eyelash extensions on my natural eyelashes, as well as use lash lift products to enhance and dye my natural eyelashes and eyebrows. Before I go forward with this procedure, I understand I must complete this agreement and provide my consent by agreeing and accepting this consent form, where indicated below.

I understand there are risks associated with having eyelash extensions applied to, or removed from my natural eyelashes. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in very rare cases, eye infection can occur. I agree that if I experience any of these medical conditions with my lashes, I will contact Beauty by Nuch (Naruenuch) and have the eyelash extensions removed immediately, and consult a physician at my own expense. I understand that even though Beauty by Nuch (Naruenuch) knows how to properly isolate and apply individual eyelash extensions, using proper techniques, the instruments, tapes, cleaners, eye gel pads, adhesives and remover is used, may irritate my eyes or require a physician’s follow-up care and subsequent removal of eyelash extensions. I understand that there are risks associated with having my natural eyelashes enhanced and dyed by using lash lift products to lift my natural eyelashes. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in very rare cases, allergic reaction can occur. I agree that if any of these instances occur, I will contact the medical physician immediately at my own expense. I understand that even though Naruenuch has been trained to properly enhance eyelashes using a keratin formula, using proper techniques, the instrument may irritate my eyes or require a physician’s follow-up care.

I understand and agree to the after-care instructions, provided by Beauty by Nuch (Naruenuch) and realise and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out, damage the extensions and/or decrease the time the lashes/eyebrows will last. I understand and consent to having my eyes closed and covered for the duration of the procedure. I understand I must close my eyes until instructed to do so, and if I open them, it is at my own cost. I understand that if I have lower lash extensions applied, I will have my eyes open, and will have instruments, tapes, cleaners, eye gel pads, adhesives, and removers used, that may irritate my open eyes, cause them to water and blink in excess, preventing application and/or requiring removal and a physician’s follow-up care and subsequent removal of the eyelash extensions.

I understand that there are many variables, including technician, expertise, hair growth cycle, use of cosmetics, skin care products, and overall care given that will influence how long my eyelash extensions lash lift will remain in place.

I agree to the following aftercare instructions and maintenance for eyelash extensions:

• No mascara waterproof, make up eyelash, curlers and extreme heat
• Brush lashes after waking up, or wet
• Remove eye makeup daily and cleanse my lashes
• Do not rub, tug or excessively touch eyelash extensions
• Must have 40% of lash extensions remaining for it to be considered a fill
• Anything less than 40% is due to an extra charge or a full set will be in place

I agree to the following aftercare instructions for eyelash/eyebrow lift enhancement:

• Not to get wet for 24 hours, absolutely no water contact
• No sauna, steam, working out (because of sweating) for 24 hours
• No mascara for 24 hours, eye makeup is just not recommended for 24 hours
• No rubbing for 24 hours

This agreement will remain in effect for all services, this procedure, and all future procedures conducted by Beauty by Nuch (Naruenuch). I read and understand this consent agreement is legal and binding. I have read and fully understand all the information in this agreement.

I am 18 years of age and consent to the agreement and treatment. I release Beauty by Nuch (Naruenuch) from all liability associated with this procedure, which is performed with the utmost attention to safety and proper application, using tools and products that the technician has been trained to use. There is no guarantee for the bonding time of eyelash extensions. Beauty by Nuch (Naruenuch) is not responsible for any technical errors. I understand the aftercare instructions and will do my part to maintain my eyelash extensions. I understand that there are many factors that may affect the life of the eyelash extensions. I verify that I have read and understood the above statements and agree to them.