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.
“Microblading“ and "Nano Brow" is a form of semi to permanent makeup tattoo that involves tattooing ink into the skin to provide fullness and shape to eyebrows. As a general approximation, the effects of Microblading may last up to 8-12 months, and Nano Brows may last up to 18 months, depending on such factors as skin type and lifestyle.
“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 MICROBLADING or NANO-BROW 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 Eyebrow MICROBLADING or NANO BROW technique, and that the final result cannot be guaranteed as each skin type is unique.
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 MICROBLADING or NANO BROW 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 EYEBROW MICROBLADING or NANO BROW is that some of the products or tools could make contact with the eyes, or eye area, resulting in temporary or permanent pain or chronic eye conditions, up to temporary or permanent vision loss. Although a low risk of infection it is possible to contract pink eye (conjunctivitis), or bacteria related infections from Staphylococcus aureus. All clients are advised not to touch their eyes without first washing their hands with hot soapy water. Infections may occur due to a contaminated environment, client's own bacteria, contaminated and/or improperly preprocesed equipment, or unclean hands touching the area.
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:
• Tap water used to dilute the ink. (Note: Ivonne Sanchez Beauty does not use tap water to dilute its pigments and instead uses steril dilution fluids).
• Contaminated and/or improperly reprocessed equipment or ink (Ivonne Sanchez Beauty adheres to sanitation protocols and does not reprocess single-use products)
• 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)”
I understand that there may be a certain amount of discomfort or pain associated with the procedure and that other adverse side effects may include minor and temporary bleeding, bruising, redness or other discolouration and swelling. Fading or loss of pigment can and may occur depending on your skin and lifestyle. Secondary infection in the area of the procedure may occur, however, if properly cared for is rare. A period of 30 days is required in order to fully heal from the procedure.
4. The minimum or maximum duration of the pigment from the procedure cannot be determined with certainty.
5. The technician and the business performing the service on me will not liable for any damages caused to me or my eyebrows in any way caused by any reason, including allergic reaction, reaction to previous procedures such as previous henna/tint, Microblading or Nano Brows on the brow hair, skin sensitivity, and my failure to follow the Aftercare Instructions. As part of the aftercare, apply a tonic and moisturizer product developed specifically for Microblading or Nano Brows to prolong the results.
I acknowledge by signing below that I have been given the full opportunity to ask any and all questions which I might have about obtaining any permanent cosmetic procedures from Ivonne Sanchez Beauty or any staff or contractor. I also acknowledge that all of my questions have been answered to my full and complete satisfaction. I specifically acknowledge that I have been advised of the fact and matters set out below, and I agree as follows:
- I acknowledge that it is not reasonably possible to determine whether I might have an allergic reaction to any of the pigments, dyes, topical preparations, or processes used in the procedure; and I agree to accept the risk that such a reaction is possible. I have informed the practitioner of any existing sensitivities.
- I understand that this is microblading or nano brows and the procedure is either performed with a blade or digital machine.
- I acknowledge that complications are possible as a result of the semi-permanent makeup procedure, particularly where aftercare instructions are not followed.
- I realize that my body is unique and the practitioner or any of the practitioner’s associates cannot predict how my skin may react as a result of the procedure.
- Red heads, blondes and fair skin types will be red, swollen and pigment MAY not retain at all. Future appointments may not be performed. This is up to the discretion of the technician.
- Results WILL appear softer as the treated area heals. The area/s treated WILL NOT look as DEFINED or as BOLD as the 1st procedure. The healing process can take 3-30 days. Everyone heals differently.
- I acknowledge that most procedures require 2 appointments and colour boosts every 1-2 years in order to keep the colour fresh.
- I acknowledge and understand that if I have oily/severely oily skin the pigment WILL heal/appear much softer and can look more “solid” due the over-production of oil glands. The pigment WILL fade quicker, look blurred or more “solid”. I accept these risks and would like to proceed. (Addendum required)
- Frequent tanning and sun exposure WILL heal darker and fade the pigment quicker. It is recommended to NOT have a tan/burn (30 days before/after) on your face at the time of your procedure. (Addendum required)
- I agree that I will not go on a sun vacation within 30 days of receiving my microblading or nano brow service, and that if I do this voids any assurances that may have been provided to me. A sun vacation will almost certainly ruin the results of microblading or nano brow. I will not be eligible for a touch-up or correction if I have been in the tropical sun.
- If you are in Menopause and suffer from hot flashes or your core temperature runs hot, your pigment will/may fade, blur or not retain.
- Frequent exercising WILL cause the pigments to fade, blur or not retain at all.
- I acknowledge and understand that pigment implanted on darker skin types (i.e. Indian, African American, Filipino etc.) the pigment will appear softer and blend more with your own skin melanin (tones) and will not appear as bold or defined as on lighter skin types and the hair strokes will be less visible.
- Alopecia clients: Due to the change in skin texture, pigments WILL heal with a “powdered” look.
- I acknowledge that the procedure will result in a permanent change to my appearance and that no representations have been made to me as to later change or remove the result.
- I understand that skin altering procedures, such as plastic surgery, implants and/or injections may alter and degrade my permanent makeup. I further understand that such changes are not the fault of the practitioner and/or any of the practitioner’s associates. I further understand that such changes in my appearance may not be correctable through further permanent makeup procedures.
- Injectibles such as Botox are not advised during the 2 weeks prior or the 2 weeks following your procedure. Your skin needs time to heal from both microblading and injectibles and these two services should not be booked within at least 2 weeks before or after each other.
- Thyroid Conditions and Medicines, WILL prevent the pigment from retaining, fade quickly, blur or change in colour. I accept these potential risks and wish to proceed.
- I ACKNOWLEDGE THAT NO GUARANTEES HAVE BEEN MADE TO ME CONCERNING THE RESULTS OF THIS PROCEDURE AND THAT THE PROFESSIONAL RECOMMENDATION IS A NATURAL LOOK.
- I accept full responsibility for determining the colour, shape and position of the brows that will be applied. Once the shape is approved and the pigment is implanted in the skin, it cannot be changed.
- I understand that the actual colour of the pigment may vary slightly due to the tone and colour of my skin.
- When you leave our studio, the hair strokes are intact. How your body heals the treated area is 100% out of the control of the technician. This is 100% your body’s job. Even when following the aftercare fading, blurring or poor retention can still happen depending on your skin type and lifestyle. This is NOT the fault of the technician.
- If you have had tattoo removal prior to seeing Ivonne, due to scar tissue the pigment may not retain. Further procedures may not be an option and I understand there are NO REFUNDS and I accept full responsibility and wish to proceed.
- If you choose to go with a darker colour for your brows at your initial appt. and later decide that you want to go lighter (lighten hair) it will not be possible to lighten the colour. Removal may be your only option.
- I understand that if I do not adhere to the strict after care instructions, I WILL ruin my results. The After Care is crucial for optimum pigment retention and results.
- I understand that should any other artist or beauty professional work on my brows that this will void any expected results and the process may need to start over again.
- Permanent makeup is an ART, NOT a science. Client results will vary from person to person and using a pencil or powder may or will still be needed. We have no control over your body’s healing process and each time a procedure is done, the pigment will have less retention due to scar tissue.
- Touch ups will not be done any sooner than the required time recommended by the technician.
- I understand that at a certain point and as the skin ages, PMU may not be possible.
- I have received and read a copy of the aftercare Instructions.
I understand that if I am receiving these services at a discounted rate e.g. as a model in the beauty training program, that the service times and work product will not be the same as a regular service and that I am willing to work with the business or the trainee to support their learning.
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 non-refundable 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