Consent And Release Agreement For Microblading Aka 3d Eyebrow Embroidery Form


Consent and Release Agreement for Microblading AKA 3D Eyebrow Embroidery
This form is designed to give information needed to make an informed choice of whether or not to undergo a
3D Eyebrow, Microblading, semi-permanent makeup application. If you have any questions, do not hesitate to
Although 3D Eyebrow Microblading is effective in most cases, no guarantee can be made that a specific client
will benefit from the procedure.
This is the process of inserting pigment into the basal layer of the epidermis. It is a form of tattooing, though
All instruments that enter the skin or come in contact with body fluids are disposable, and disposed of after
use. Cross contamination guidelines are strictly adhered.
Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual and
advised to expect a Touch-Up after healing is completed.
Initially, the color will appear more vibrant or darker compared to the end result. Usually, within 5-7 days, the
color will fade 40-50%, soften, and look more natural. The pigment is semi-permanent and will fade over
time. Additional Touch-Ups are likely needed within 6 months to 2 years.
Photography Release Consent
We would like your permission to use these photos for advertising. For example: Portfolios, online and print
ads, etc. Your consent is necessary regarding this. Please circle and indicated with your signature if you would
like your photos used or not used in advertising.
Yes, feel free to use them
No, please do not use them
Print Name
Email _________________________________________________________________________
Phone ________________________________________________________________________
Special requests, concerns, or remarks for the Artist


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