Blushed Studios

Permanent makeup consent

Please review each section carefully and provide complete, accurate information before treatment.

PERMANENT MAKEUP CONSENT FORM

Blushed Studios LLC

CLIENT INFORMATION

Full Legal Name:

Last name

Date of Birth

Phone Number:

Email Address:

Street Address:

EMERGENCY CONTACT

Name:

Relationship

Phone Number

APPOINTMENT INFORMATION

Appointment Date:

Procedure/Service:

Artist:

GENERAL UNDERSTANDING

I understand that permanent makeup (cosmetic tattooing) involves the implantation of pigment into the skin and that results may vary from person to person.

I understand and acknowledge that:

Permanent makeup is intended to be long-lasting but will gradually fade over time.

Results may vary depending on skin type, lifestyle, medications, sun exposure, aftercare, healing response, and other individual factors.

Multiple sessions or touch-ups may be necessary to achieve or maintain the desired result.

Pigment color and appearance may change during the healing process.

Permanent makeup procedures involve risks and possible complications, which have been explained within this consent form.

I have read and understand the information above and acknowledge the nature and limitations of permanent makeup.

MEDICAL & HEALTH INFORMATION

If you selected any of the above, please explain:

Medical Disclosure

I certify that the medical and health information I have provided is complete and accurate to the best of my knowledge. I understand that withholding relevant medical information may increase my risk of an adverse reaction or complication.

I have truthfully disclosed all relevant medical conditions, medications, allergies, sensitivities, and previous procedures.

RISKS & POSSIBLE COMPLICATIONS

I understand that permanent makeup procedures may involve risks or complications, including but not limited to:

Redness, tenderness, swelling, bruising, or temporary discomfort
Infection
Allergic or sensitivity reactions
Scarring or changes in skin texture
Uneven pigment retention or premature fading
Pigment color changes
Asymmetry or variations in healed results
Pigment migration or spreading
Need for additional sessions, touch-ups, correction, or removal
Unsatisfactory cosmetic results
Cold sore outbreaks following lip procedures in individuals susceptible to them

I have read and understand the risks and possible complications listed above and voluntarily accept these risks.

AFTERCARE RESPONSIBILITY

I understand that proper aftercare is an important part of the healing process and can affect my final results. I agree to follow the written and/or verbal aftercare instructions provided by Blushed Studios LLC.

I understand that failure to follow aftercare instructions, picking or scratching the treated area, excessive sun exposure, swimming, sweating, use of certain skincare products, or other activities during healing may negatively affect my results or increase the risk of complications.

I have read and understand my aftercare responsibilities and agree to follow the aftercare instructions provided to me.

TOUCH-UPS & PIGMENT RETENTION

I understand that healed results and pigment retention vary from person to person. Permanent makeup may heal lighter, unevenly, or with areas of reduced pigment retention.

I understand that a touch-up or additional session may be necessary and that future maintenance may be required as the pigment naturally fades over time.

I understand that pigment retention and healed results vary and that touch-ups or additional sessions may be necessary.

NO GUARANTEE OF RESULTS

I understand that every person’s skin, healing response, and pigment retention are different. While every reasonable effort will be made to achieve the desired result, Blushed Studios LLC cannot guarantee a specific color, shape, symmetry, pigment retention, longevity, or final healed appearance.

I understand and acknowledge that no specific permanent makeup result can be guaranteed.

PHOTOGRAPHY CONSENT

Please select one:

I GIVE permission to Blushed Studios LLC to photograph and/or record my treatment area and use the images for client documentation, educational purposes, portfolio, website, social media, advertising, and other marketing purposes.

I DO NOT GIVE permission for my photographs or recordings to be used for marketing or promotional purposes.

RELEASE OF LIABILITY

I understand that permanent makeup is an elective cosmetic procedure and that individual reactions and results cannot be predicted with certainty.

I acknowledge that I have disclosed relevant medical information, have been informed of the nature of the procedure and its potential risks, and have had the opportunity to ask questions.

To the extent permitted by applicable law, I voluntarily assume the known and disclosed risks associated with the procedure and release Blushed Studios LLC and the performing artist from claims arising from those inherent risks, except where liability cannot legally be waived.

I have read and understand the Release of Liability above and voluntarily agree to its terms.

FINAL CLIENT ACKNOWLEDGMENT & CONSENT

By signing below, I confirm that:

I am at least 18 years of age.

The information I have provided on this form is complete and accurate to the best of my knowledge.

I have read and fully understand this consent form.

I understand the nature and purpose of the permanent makeup procedure I am receiving.

I have had the opportunity to ask questions and receive answers before proceeding.

I understand the potential risks, limitations, healing process, aftercare responsibilities, and possibility of additional sessions.

I understand that permanent makeup results cannot be guaranteed.

I voluntarily consent to the permanent makeup procedure selected above and authorize Blushed Studios LLC and the performing artist to perform the procedure.

Printed Name:

Client Signature:

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Date: