Consent Form for Eyebrow Lamination and Tint
(Please read thoroughly)
Client Information:
Full Name: ___________________________________________________
Date of Birth: ________________________
Phone Number: ______________________
Email: ________________________________________________________
1. Brow Tint:
- Brow tinting involves applying a semi-permanent dye to darken the color of the eyebrows.
- The dye may contain ingredients such as hydrogen peroxide, p-phenylenediamine, or other colorants.
- The tinting process typically takes around 10-15 minutes.
[ ] I choose to proceed with the brow tinting services without a patch test.
[ ] I request to undergo a patch test.
2. Brow Lamination:
- Brow lamination is a technique that helps to shape and set the brow hairs in a desired position.
- The process involves the use of a chemical solution to break down the bonds of the brow hairs, followed by repositioning and fixing them into the desired shape.
- The lamination process typically takes around 30-45 minutes.
[ ] I choose to proceed with the brow lamination services without a patch test.
[ ] I request to undergo a patch test.
3. Risks and Limitations:
- Although rare, there is a possibility of an allergic reaction or skin irritation from the tint or lamination products. Patch testing is recommended prior to the procedure.
- Brow tinting and lamination results may vary depending on the natural color and thickness of the eyebrow hairs.
- Brow lamination may cause temporary redness or sensitivity around the brow area immediately after the procedure.
- Results may last between 4-8 weeks, depending on individual hair growth and aftercare.
4. Allergy Checkpoint:
[ ] I confirm that I am not allergic to any adhesives or other cosmetic products that may be used during the eyebrow lamination and tint procedure.
5. Honest Communication Checkpoint:
[ ] I agree to be honest in telling my stylist of any allergies I may have or am aware of before the procedure.
Allergies: ____________________________________________________________________________
6. Aftercare Instructions:
[ ] I agree to follow the provided aftercare instructions, including not touching or wetting the brow area for at least 24 hours, avoiding makeup on the brows for the first 24 hours, and using recommended brow serums or oils for maintenance.
7. Health Checkpoint:
[ ] I confirm that I am not pregnant or have any other serious illness. If I am pregnant or have a serious illness, I will provide a doctor's note stating that it is safe for me to receive the eyebrow lamination and tint service.
[ ] Check this box only if you are pregnant or have a serius illness, but have provided me with a doctors note
8. Cancellation Policy:
[ ] I understand that if I need to cancel or reschedule my appointment, I must provide at least 24 hours' notice. Failure to do so or not showing up without prior notice will result in being charged the full price of the service.
9. Photography Release:
- I grant permission for the stylist to take photographs of my eyebrows before, during, and after the procedure for documentation and promotional purposes.
[ ] Yes
[ ] No
10. Chemicals to Avoid:
[ ] Prior to the procedure, I agree not to apply any retinol, AHAs, BHAs, or other exfoliating or irritant products to my face for at least 48 hours.
I have read and understood the above information regarding the eyebrow lamination and tint procedure. I have had the opportunity to ask any questions I may have, and all my questions have been answered to my satisfaction.
Client's Signature: ___________________________________________________
Date: _____________________________
Consent given by: (Please check one)
[ ] Client above, if 18 years or older
[ ] Parent/Legal Guardian, if client is under 18 years old
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