Client Consent Form
Personal Details
Please answer the following questions truthfully in order for us to complete your consultation
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Medications currently being taken (tick if applicable)
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Medical conditions/Treatments past or present (tick if applicable)
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Please read carefully before signing this release form
I understand that semi permanent make-up is a process and may require more than one application to achieve the desired result. I understand that one re-touch session is free (excluding Models and exhibition clients) and included in the cost of the original procedure. Subsequent visits are subject to a £75.00 materials fee per procedure.
I have received an allergy test and received information relating to this prior to receiving the procedure. I thereby release Active Clinics (Active Group International Ltd.), the Technicians and all agents from any liability related to an allergic or other reaction to applied pigments.
I understand that after having the procedure I may encounter some elements of swelling and possible scabbing of the area treated for approximately 7-10 days. It has been explained to me that it depends entirely on an individual's reaction and their unique recovery rate. Also, there may be a slight change in the colour implanted due to individual's skin acidity. Usual lightening of initial treatment is 30-40%.
I have been advised that if I have the herpes simplex 1 virus that causes cold sores on lips, semi permanent make-up procedures traumatising that area may stimulate a cold sore outbreak. I have been advised to speak to my doctor for a prescription of Zovirax which may prevent this occurring.
I acknowledge that no guarantees have been made to me concerning the results of this procedure. I have read and fully understand the content of this consent form. I accept full responsibility for the cosmetic procedure(s) being carried out at my request according to this consent and procedure form.