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 Permanent Makeup Procedure
Consent Form

Client Information

Treatment Selection

Please select the service(s) you are receiving today:
Brow Tinting
Brow Waxing
Brow Tinting & Brow Waxing

Medical History

Please check any that apply:

If applicable, please explain:

Consent & Acknowledgment

  • I understand that brow tinting uses a semi-permanent dye to enhance the appearance of my eyebrows and that results will gradually fade over time.


  • I understand that brow waxing removes unwanted hair using wax and may cause temporary redness, tenderness, or mild irritation.


  • I understand that individual results vary depending on my skin type, hair growth, skincare routine, and aftercare.


  • I understand there is a possibility of allergic reactions, skin irritation, redness, swelling, sensitivity, bruising, lifting of the skin, or uneven results despite proper application.


  • I understand that no guarantees have been made regarding the outcome or longevity of the treatment.


  • I understand that I should inform my technician immediately if I experience excessive discomfort during the procedure.


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


  • I voluntarily consent to receive the selected treatment(s).

Aftercare Acknowledgment

I understand that following the recommended aftercare instructions will help achieve the best possible results.


For the first 24 hours, I will avoid:


  • Excessive sweating

  • Steam rooms and saunas

  • Swimming

  • Scrubbing or rubbing the treated area

  • Oil-based products directly on the brows

  • Excessive sun exposure

Photography Release (Optional)

Liability Release

I release Blushed Studios and its employees from liability for any adverse reactions or complications that may occur as a result of my failure to disclose relevant medical information, allergies, medications, or failure to follow aftercare instructions.


I understand that every precaution will be taken to ensure my safety and comfort during my treatment.

Client Signature

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Location

33 W. Hoffman Ave., Lindenhurst, NY 11757

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