I am over the age of 18 and desire Sarah Giannola Owner of Beyou Microblading LLC, to perform the elective cosmetic pigmentation procedure understanding that this procedure is for cosmetic purpose only and not for health reason. If any unforeseen conditions arise during this procedure calling for his/her judgment for procedures in addition to, or, different from those now contemplated, I further request and authorize him/her to do whatever necessary in the circumstances. I am aware that no guarantees have been made to me concerning the results of the procedure(s).
November 21, 2024 I also understand that the permanent skin pigmentation procedure carries with it the possible complication and consequences associated with this type of cosmetic procedure, which includes risk of infection, scarring, eye damage, inconsistent color, hemorrhage, and possible spreading, fanning, or fading of pigments and or allergic reaction to any products used. I understand the actual color of the pigment may be modified slightly due to the tone and color of my skin. Laser and Acids treatments may also compromise the semi permanent cosmetic make-up application (you should stop them 15 days before any procedure). I fully understand as with all such procedures that this is not a science but rather an art and that anything can go wrong. I request the permanent skin pigmentation procedure, appreciating and accepting the permanency of the procedure as well as the possible complications and consequences of the said procedure(s).
November 21, 2024 For the purpose of documentation, I also consent to the taking of before, during and after photographs / videos of said procedure (s) which become the technician’s sole property and may or may not be used for whatever purpose deemed necessary including using pictures for social media and advertising publications. Understanding the permanent skin pigmentation procedure, the procedure, the permanency of the procedure, and that the procedure is for cosmetic purposes only, I hereby authorize Sarah Giannola Owner of Beyou Microblading LLC, to perform the semi permanent skin pigmentation procedure(s).
November 21, 2024 I certify that I have read and initialed the above paragraphs and have had explained to me and fully understand the above consent and procedure permit; that the explanations therein referred to were made and I accept full responsibility for these and/ or any other complications which may arise or result during or following the cosmetic procedure(s) which is to be performed at my request according to this consent were filled in before I signed this statement.
November 21, 2024 Microblading/Nanoblading procedures normally require multiple treatment sessions. For best results clients will be required to return for at least one re-touch appointment. This will take place 4 -6 weeks after the initial procedure. Those with oily skin may require an additional touch up. Please be aware that color intensity will be significantly darker and sharper immediately and a few days after the initial procedure, but the color will reduce by up to 40%.
November 21, 2024
Client Treatment Consent and Release I acknowledge that beauty treatments, the practice of skin care, and the practice of massage, including, but not limited to, microablation, microdermabrasion, waxing, electrolysis, facial toning, permanent cosmetics, body treatments, ionization, laser treatments, tattoo removal, vein treatments, brown spot removal, BOTOX, Collagen, Dermal Fillers, PRP Injections, Sclerotherapy, Mesotherapy, Dermaplaning, and various other beauty procedures is not an exact science and no specific guaranties can or have been made concerning the outcome. I understand that some clients experience more change and improvement than others. In virtually all cases, multiple treatments are required in order to realize a difference.
November 21, 2024 I also understand and agree to assume the following risks and hazards which may occur in connection with any particular treatment including but not limited to: unsatisfactory results, soreness, poor healing, discomfort, redness, blistering, nerve damage, scarring, infection, change in skin pigmentation, allergic reaction, muscle damage, and increased hair growth. I understand that even though precautions may be taken in my treatment, not all risks can be known in advance.
November 21, 2024 Given the above, I understand that response to treatment varies on an individual basis and that specific results are not guaranteed. Therefore, in consideration for any treatment received, I agree to unconditionally defend, hold harmless and release from any and all liability the company Beyou Microblading LLC, and the individual that provided my treatment, the insured, and any additional insureds, as well as any officers, directors, or employees of the above companie for any condition or result, known or unknown, that may arise as a consequence of any treatment that I receive.
November 21, 2024 I have fully disclosed on my client intake form any medications, previous complications, or current conditions that may effect my treatment. I understand and agree that any legal action of any kind related to any treatment I receive will be limited to binding arbitration using a single arbitrator agreed to by both parties.
November 21, 2024 I agree to binding arbitration or mediation in the event I wish to file a lawsuit against Sarah Giannola, Owner of Beyou Microblading LLC for any legal issues I have with my procedures.
Date: November 21, 2024
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