Loading...

PATCH TEST FOR PERMANENT MAKE-UP

The anaesthetic and pigment will be tested for sensitivity. The skin will be superficially pricked behind your ears and the anesthetic and pigment will be applied to the skin. After 24-48 hours your skin should be checked to see if there's any reaction.

If there is no reaction - no itching, redness, swelling or irritation, then it is safe to proceed with the treatment. Should you experience any of the above, the please clean the area of product immediately and contact the salon to advise of the results.

If there is no reaction, then you can go ahead with the procedure, as discussed.

During your pre-treatment consultation, the correct colour pigment will be mixed to check for the desired look and this will become the pigment patch test.

Location of test: Love Brows. 1914 Charlotte Ave. Nashville, TN 37203

I have undertaken a sensitivity patch test and have not suffered any adverse effects.

Today's Date: May 19, 2025

First Client's Name
First Name*
Middle Name
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
First Client's Information
Test date
Technician:
First Client's Signature*
Second Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Second Client's Information
Test date
Technician:
Third Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Information
Test date
Technician:
Fourth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Information
Test date
Technician:
Fifth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Information
Test date
Technician:
Sixth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Information
Test date
Technician:
Seventh Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Information
Test date
Technician:
Eighth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Information
Test date
Technician:
Ninth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Information
Test date
Technician:
Tenth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Information
Test date
Technician:
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
Test date
Technician:
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!