All information is collected by Ivonne Sanchez Beauty pursuant to O. Reg. 136/18: PERSONAL SERVICE SETTINGS and The Personal Information Protection and Electronic Documents Act (“PIPEDA “).
The words “I”, “you” and “your" are used interchangeably throughout this agreement and in all cases refer to you the client who is receiving the treatment or procedure.
“Practitioner”, “technician”, “instructor” and “we” means 10981508 CANADA INC. (“Ivonne Sanchez Beauty”), its staff or contractors.
SECTION 1: ACKNOWLEDGMENTS AND AGREEMENTS
Please read each statement and sign the end of this document to accept your acknowledgement and agreement to the following:
That I have been given a copy of this Consent and Liability Release (the "Release") prior to the CAMOUFLAGE TATTOO technique being performed on me.
That it is my responsibility to advise the technician of any concerns I may have before participating as a client/customer and having this service performed on me, even though I may have written it down in this Release.
That I have read and accepted the risks set forth in Section 2. I have been given the opportunity to ask questions, either by written or verbal communication, prior to signing this Release. As a result, I have sufficient information to give this informed consent.
That I must complete the Health Questionnaire in Section 3 before I can have this service performed on me. I understand my participation as a client may be refused depending on my responses, including but not limited to, if I am pregnant, nursing or if I have any allergies or contraindications.
That no warranty or guarantee has been made to me as a result of the Camouflage Tattoo technique, and that the final result cannot be guaranteed as each skin type is unique. Multiple treatments may be required in order to achieve the closest desired effect.
SECTION 2: RISKS
I acknowledge and accept the following risks:
1. During the treatment, despite all precautionary measures, injury is possible. I will not hold the technician or business performing this service on me responsible in any way for any damages or issues that may arise as a result of having the Camouflage Tattoo procedure performed on me.
2. Despite application of the most advanced and top ingredients, an allergic reaction is possible.
3. Despite all measures taken, the risk of with Camouflage Tattoo is that some tattooing induces physical damage to the skin, which may cause or promote infections if microorganisms are introduced under the skin during the process. The potential sources of microorganisms include:
- Contaminated dilution mediums.
- Contaminated and/or improperly reprocessed equipment or ink
- Client’s own bacteria on the skin.
- Unclean hands touching the treatment area.
Potential infections can be caused by bacteria (e.g., Mycobacterium spp. or Staphylococcus aureus), fungi (e.g., Candida endophthalmitis), or even viruses (e.g., human immunodeficiency virus [HIV], hepatitis B virus, hepatitis C virus). There have been outbreaks of bacterial infection (non-tuberculous mycobacterial) caused by ink that was contaminated prior to distribution. Such bacterial infection can cause several diseases such as lung disease, joint infection, eye problems, and other organ infections.
4. Although Camouflage Tattoo is considered to be permanent, the minimum or maximum duration of the pigmentation from the procedure cannot be determined with certainty. I understand that additional treatments may be required in order to achieve desired immediate results.
5. The technician and the business performing the service on me will not liable for any damages caused to me or my body in any way caused by any reason, including allergic reaction, reaction to previous procedures such as previous micropigmentation, or cosmetic tattoo on the skin, skin sensitivity, and my failure to follow the Camouflage Tattoo Aftercare Instructions. The use of after care products is required to achieve optimal results.
It is strongly recommended to avoid physical exercise the first 7 days.
I understand that it is forbidden to sunbathe for a minimum or 40 days.
I understand that in the first 30 days it is forbidden to use sunblock, self tanning lotion or any substance that contains vitamin D or that stimulates the production of vitamin D, or any agent with photosensitizing agents.
I understand that should any other artist or beauty professional work over the treated area that this will void any expected results and the process may need to start over again.
I understand that the following 11 items are contraindications (conditions) that may disqualify me as a candidate for permanent makeup procedures:
- Infected skin disorder, open cuts, wounds, abrasions
- Patients with cardiovascular disease must have doctor’s consent
- A pacemaker is a direct contra-indication
- Highly anxious
- Epileptic – electrical currents may precipitate an attack
- Pregnancy – electrical currents may precipitate labor
- Sunburned or irritated skin
- Untreated sinusitis – can cause pain in sinus area
- Numb area without sensation
- Diabetes – a separate consent from physician may be required
- If currently taking blood thinners
If the skin becomes painful and increasingly red, then you may have developed an infection and you must consult your physician immediately.
In most cases, redness will begin to subside within 2-4 days, some cases may take longer if a more aggressive treatment is performed. Pinkness may take up to one month to fade. This is not uncommon.
I understand that the treated area can remain pink for up to 1 month or sometimes longer and will gradually lighten with time. (Each client will heal differently).
AVOID EXPOSURE TO DIRECT SUNLIGHT UNTIL THE AREAS HAVE COMPLETELY HEALED. (40 days)
I have read and understand the contents of this consent.
Cancellation Policy and Reminders.
All bookings are recorded in an online booking system. This system will send an e-mail confirmation to you of your scheduled appointment at the time that the scheduling is made. The booking system will also send a follow-up reminder e-mail 24 hours prior to your scheduled appointment. Unfortunately, we do not have a telephone reminder service.
A $100 deposit is required in order to make a booking for services. This will be applied to your scheduled service subject to the cancellation policy.
All cancellations and appointment rescheduling requests must be made at least 48 hours prior to the start of your scheduled appointment time.
The following events will result in the loss of the $100 booking deposit:
- Cancellations without a minimum of 48 hours notice; or
- Cancellations with 48 hours notice but where a new booking is not made
I understand and agree to the above cancellation policy.
Customer Satisfaction and Feedback.
If I am unhappy with the results or service, I will not take to the internet to air my grievances of Ivonne Sanchez, Ivonne Sanchez Beauty in any online forum including but not limited to: Google Reviews, Facebook Reviews, Instagram, Facebook, or Twitter. I will instead contact Ivonne privately in order to allow her to work with me to find a solution.
Today's Date: July 3, 2020