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T MARIE PMU, LLC

Microblading - Nano - Lip Blush

 Machine PMU

San Diego, CA - Denver, CO

What is Microblading / Nano?

Microblading is done using a manual tool with nano sized needles to implant pigment into the skin. Nano is done using a machine and single needle to implant pigment into the skin. Both methods are effective in achieving natural looking results - at your appointment we will discuss which technique is best for your skin type and brow goals!

With Microblading and Nano, the pigment is implanted in the basal membrane, which divides the epidermis from the Dermis layer of the skin. This creates very crisp, fine hair strokes that will soften over time!

What is Combination Brow?

A combination brow is Microblading/Nano with the addition of machine shading. Hair-like strokes are placed throughout the brow to give the brows a natural look. The powder effect is applied to the body, or the innermost part of the brow using a permanent makeup machine to give the brow its fullness. This method of PMU is great for clients with very oily skin, clients wanting a fuller brow or clients with dense hair in only one part of the brow. The powder shading gives the brow more body while the hair strokes keep the brow looking natural.

What is the typical cost for Microblading / Nano?

Remember you get what you pay for! Competitors may charge differently, but this requires a higher price tag, brows frame the face so it's critical they are perfect.

  • Free optional consultation (Only absolutely necessary if you have previous tattooing or Microblading on your brows, or if you are over the age of 65, we can set up a virtual consultation! Please text: 720-924-2315)
  • Initial treatment for brows - Pricing Variable - Check Appointment Confirmation, consult not required **if you have previous Permanent make-up on the brow area we will need to do a consultation** Send photos to 720-924-2315
  • No-show for an appointment without rescheduling will result in a $100 fee charged to the card on file.
  • Touch-up 5-10 weeks after Initial Treatment - Variable. (Price subject to change.) Price includes 1 session.
  • Touch-up (within 1 year of first session) - Variable. (Price subject to change.) Price includes 1 session.
  • Touch-up (within 2 years of first session) - Variable. (Price subject to change.) Price includes 1 session.
  • Any visits after the initial and first touch up will incur a cost of $50+ (minimum).
  • Book your "touch up" after the allotted 10 week- Price is $200.

How long does it last? 

Everyone is different; it can last 1-3+ years. We suggest yearly touch-ups; however, some clients desire a touch-up every 6-12 months while other clients won’t return for a touch-up until year 2 or 3. 

Main factors in how long results last depend on age, skin type and sun exposure.

Does it hurt?

This is designed to be a gentle procedure with minimal to no discomfort! A topical numbing cream is used prior to beginning. A secondary numbing cream is then applied which is absorbed into the bloodstream within a few seconds. Once the secondary numbing has absorbed, you will have very little feeling and in most cases no feeling at all! 

Non-Candidates for PMU:

  • Over that age of 65 (Dependent on the individual, will be determined after skin evaluation)
  • Previous tatttoo/microblading on brow area (We need to schedule a consultation) 
  • Have recieved Covid-10 Vaccine (need to wait 2 weeks before/after vaccine)
  • Pregnancy or nursing
  • Diabetic patients
  • Skin diseases
  • Directly after Botox treatment (after 2 weeks is allowed)
  • Use of Accutane, Isoltretinoin, or other retinoids (after 6 months is allowed)
  • If you have a pacemaker, this manual method can be used, but any machine use is not allowed.
  • Very sensitive and pain intolerant
  • Sunburn or frostbitten (allowed after symptoms are gone)
  • Seborrhea Dermatitis
  • Very dry or peeling skin
  • Excessive sebum, oily skin (Combination brows are great for oily skin types!)
  • Problem skin broken capillaries
  • Acne
  • Moles
  • Keratosis
  • Very dry or peeling skin
  • Problem skin

READ ME:

- We do not accept clients with previous PMU, Microblading, Lip Blush, Cosmetic Tattooing, Etc on the treatment area without a consultation first. Text photos (with no make-up on) to 720-924-2315

- If you are over the age of 65 we must do a consultation before you may book an appointment. It is imperative that we access the skin to ensure you are a good candidate for permanent makeup.

-Failure to adhere to the above policies will result in your appointment being cancelled and you will be charged a fee of $100. No exceptions

I have read and understand the above policies. 


Initial Consultation:

  • We provide free consultations if needed. The consultation will be approximately 20-30 minutes; this will not be your procedure day unless previously agreed upon.
  • If you require a Patch Test, it must be completed 48 hours before your treatment, or you can sign a waiver on the day of your treatment.
  • We take a photo of you so we can study the symmetry of your features. No one is exactly the same, and what we see as your ideal brow might not be what you want, we want to achieve your perfect brow. Our goal is to obtain symmetry and communicate realistic expectations. Please remember we can't make you look like your favorite celebrity; we are brow artists not plastic surgeons. Miracle beautiful brows that are true to YOU we can do. Be your own beautiful!

Before the Treatment:

**If any of these items occur, we will be forced to cancel your appointment and you will be charged a $100 fee**

  • DO NOT take Aspirin, Niacin, Vitamin E, Fish Oil or Ibuprofen 48 hours before.
  • DO NOT drink caffeine, alcohol or energy drinks on the day of treatment!! AND 1 day before treatment.
  • ** This is EXTREMELY important ***These substances thin the blood, which will alter pigment color, cause discomfort/excessive bleeding and result in poor results.
  • If you tint your brows, do it 1-2 weeks prior to treatment
  • Do not tan or sunbathe 1 week before treatment.
  • You must complete any waxing at least 2 days before the treatment.
  • Any and all Botox is recommended to be done 4 weeks prior to treatment.
  • No chemical peels, dermabrasion, mesotherapy or any other intense treatments. This will cause skin cells to rejuvenate faster which will result in skin irritation. We recommend any of these to be done 2-3 weeks before microblading.
  • If you do not tell us you've had previous work on your brows (ie... microblading, tattooing, laser, removal, etc...) your appointment may be cancelled.
  • Fix and/or wash your hair before the treatment. You will not be able to have direct contact with water on the brow area for 10-14 days. You may still shower and wash your hair- I will explain how to do so at our appointment.

On the Treatment Day:

  • Please arrive least 10 minutes before your appointment. Late arrival will NOT be accepted, please call us; it can lead to your treatment being postponed to another day. You will forfeit your deposit. If you are late on the day of your touch up, you will incur a $50 fee to rebook the touch up. We appreciate you contacting us when you are running late due to unforeseen circumstances, however, we run on a very tight schedule and cannot accept tardy clients.
  • At the start of your appointment we clean your brow area with sterile, hygienic pads and draw the brow form on to your skin.
  • A photo will be taken, often times a photo will show defects or issues that may need to be addressed.
  • You will approve the brow shape before we continue on with numbing.
  • We use a disposable microblading tool and disposable blades during your procedure.
  • We use EU Regulated Permanent Makeup high quality pigments, specially manufactured for microblading.

Treatment Steps (procedure usually takes approximately 2 hours):

  1. Consultation discussing treatment, shape and pigment color.
  2. Shape is drawn with a soft pencil.
  3. Numbing cream is applied to the skin; this takes approximately 20 minutes to take effect.
  4. Pigment is applied with a manual tool/and or machine using our technique.
  5. Pigment is left to absorb and work its magic!
  6. We clean the area.
  7. Take a look at your new, gorgeous brows!

After the Treatment

  1. Aftercare will be discussed.
  2. Touch-up appointment will be scheduled 5-10 weeks from the date of initial treatment. *If touch-up appointment is not completed within 5-10 weeks from the initial brow treatment, a $50 fee will be required for the touch-up appointment.

I've read and understand the above information.

T MARIE PMU, LLC Microblading / PMU Aftercare Instructions

After care is very important in order to achieve a beautiful and lasting result.

  • Water or any other liquids cannot come in contact with the affected area for 10-14 days after microblading, even a small drop will expand a wound and a scab will appear.
  • Apply a thin layer of the given "Balm" 1-3 times daily for 2 weeks. If your skin is oily make sure you keep your brows clean and dry. If your skin is dry, you can apply the balm more times if needed.
  • If itching occurs, you can use Bactine, and it will also disinfect the area. Bactine contains lidocaine and benzalkonium chloride.
  • After 10-14 days, as long as the brows are no longer scabbing, you can use a gentle soap or nongreasy cleaner to keep your brows clean.
  • Do not use any other ointments, or creams with vitamins or antibiotics on brows while healing.
  • No sunbathing or tanning for 4 weeks.
  • No chemical peels, mesotherapy, dermabrasion, Botox or any other intense treatments for 4 weeks.
  • Do not use any makeup on affected area for 2 weeks.
  • Do not scratch, touch or sleep on your brows for at least 2 weeks.
  • No heavy workouts for 10-14 days. Avoid sweating and elevating heart rate.
  • Sometimes residual pigment, blood, white blood cells, etc., can arise from the open wound, if this occurs you should gently dab this away. Don't panic if dry patches or scabs appear as this can be taken care of in the second touch-up appointment.
  • Avoid Petroleum Jelly or Vaseline during your healing period. Anything with a petroleum base can cause a reaction, crusting, scabbing and sweating so the skin is not able to breathe.
  • For the service with any permanent make up procedure results may vary and everyone’s skin and bodies heal different there is no guarantee that it will be perfect after one session. It can take weeks to tell what the healed results will look like, with eyebrows and lips the color may disappear and come back. True color takes a full 4-6 weeks to be seen. Not everyone’s healing experience is the same and can not be compared. Please be patient and trust the procedure. Can’t wait to see you!

What's normal?

-Mild swelling, itching, light scabbing, light bruising and dry tightness. Aftercare balm is nice for scabbing and tightness.

-Feeling too dark. After 2-7 days the darkness will fade and once swelling dissipates any feeling of unevenness usually disappears. If they are too dark or still a bit uneven after 5 weeks, then we will make adjustments during the touch up appointment.

-Color change or color loss. As the procedure area heals, the color will lighten and sometimes seem to disappear. This can all be addressed during the touch up appointment and is why the touch up is necessary. The procedure area has to be completely healed before we can address any concerns. This takes about five weeks.

 

Healing Process and Touch-Up:

  • If you keep your brows clean and dry, only a thin film (not a scab) will appear after 4-7 days. It will peel off itself in 7-10 days (do NOT peel it off). After the film peels off you can still feel some dryness, in this case clean or disinfect the area with a small amount of coconut or grape seed oil. Be careful with any cleaning in the affected area. The full healing period is 28-45 days.
  • If there is any contact with water, sebum or sweat, the wound will expand and cause a scab. The scab will result in itching and peeling of the pigment. If you scratch the scab, a scar or white spot can appear, and no pigment will be left.
  • If you have an old tattoo, note that microblading will NOT fully cover your tattoo. It will still likely be visible through the microblading strokes. Only another "blocky" procedure, like a brow tattoo, may cover what you already have. Due to the process that microblading is, tattoos are unable to be fully covered. Previously tattooed clients likely require more than 2 sessions. This can occur because of the built-up scar tissue in the brow area from the tattoo. If you would like more than 2 sessions, a fee will be assessed. We do our best to cover the existing tattoo and color match but again, due to previous work on the skin, the result will not always be ideal.
  • Needing a touch up months or years later. A touch up may be needed 6 months to 2 years after the touch up procedure depending on your skin, medications and sun exposure. We recommend the touch up 5-10 weeks after the first session and every 6 months to 2 years to keep them looking fresh and beautiful. There will be a charge for any touch up sessions after 10 weeks. **Failure to follow after care instructions may result in infections, pigment loss or discoloration. Everyone's skin heals differently. It is important to remember that this is a two-part process and the second touch-up will complete the procedure. The touch-up is recommended between 5-10 weeks. Not everyone, but some people will need a touch-up to fill in missing hairs, make hairs longer or achieve a more intensive color. After you have fully healed, you will see the finished result. Please be patient.

I have read, understand and agree to the above instructions.


 

Consent and Release Agreement for Microblading / PMU

This form is designed to give information needed to make an informed choice of whether or not to undergo a Microblading Treatment. If you have questions, please don’t hesitate to ask. Although Microblading is affective in most cases, no guarantee can be made that a specific client will benefit from the procedure.

Microblading is the process of inserting pigment into the dermal layer of the skin and is a form of tattooing. All instruments that enter the skin or come in contact with body fluids are sealed and sterilized before use and disposed of after use. Cross contamination guidelines are stickily adhered to. Artist is annually BBP Certified and Licensed.

Generally, the results are excellent. However, a perfect result is not a realistic expectation. It is usual to expect a touch-up after the healing is completed.

Initially the color will appear much more vibrant or darker compared to the end result. Usually within 7-10 days the color will fade 10-30%, soften and look more natural. The pigment is semi-permanent and will fade over time and will likely need to be touched-up within 6 months to 2 years.

I have read, understand and agree to the above instructions.


 

Possible Risks, Hazards, or Complications

  • Pain: There can be discomfort even after the topical anesthetic has been used. Anesthetics work better on some people than on others. Most of the time there is little to no discomfort!
  • Infection: Infection is very unusual. The areas treated must be kept clean, and only freshly cleaned hands should touch the areas. See After Care sheet for instruction on care.
  • Uneven Pigmentation: This can result from poor healing, infection, bleeding, or many other causes. Your follow-up appointment will likely correct any uneven appearance.
  • Asymmetry: Every effort will be made to avoid asymmetry, but our faces are not symmetrical so adjustments may be needed during the follow-up session to address any unevenness.
  • Excessive Swelling or Bruising: Rarely people bruise or swell. Ice packs may help reduce the swelling. The swelling or bruising typically disappears in 1-5 days. It’s important to note that most people don’t bruise or swell at all. 
  • Anesthetics: Topical anesthetics are used to numb the area to be tattooed. Lidocaine, Prilocaine, Benzocaine, Tetracaine, and/or Epinephrine cream and/or liquid are used. If you are allergic to any of these, please inform me now. 
  • MRI: Because pigments used in Permanent Cosmetic procedures contain inert oxides, a lowlevel magnet may be required if you need to be scanned by an MRI machine. You must inform your MRI Technician of any tattoos or permanent cosmetics.

The alternative to these possibilities is to use traditional cosmetics and NOT undergo the SemiPermanent Eyebrow procedure.

I certify that I have read or have had read to me the contents of this form. I understand the risks and alternatives involved in this procedure(s). I have had the opportunity to ask questions, and all of my questions have been answered. I acknowledge that I have reviewed and approved the material given to me, and I authorize T MARIE PMU, LLC, as my eyebrow microblading technician to perform on my body the Microblading procedure desired today.


I have been informed of the nature, risks, and possible complications and consequences of permanent skin pigmentation. I understand the permanent skin pigmentation procedure carries with it known and unknown complications and consequences associated with this type of cosmetic procedure, including but not limited to: infection, allergic reaction, scarring, inconsistent color, and spreading, fanning or fading of pigments. I understand the actual color of the pigment may be modified slightly, due to the tone and color of my skin. I fully understand this is a tattoo process and therefore not an exact science, but an art. I request the microblading procedure and accept the permanence of the procedure as well as the possible complications and consequences of the said procedure. I understand that while this is sometimes referred to as semi-permanent in nature, due to each individual’s reaction to pigment, the length of time pigment is present cannot be guaranteed. In some cases, pigment will be permanent.


I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my permanent cosmetics. I acknowledge some of these potential adverse changes may not be correctable.


I have received pre- and post-procedure instructions and I will strictly adhere to such instructions. I understand that my failure to do so may jeopardize my chances for a successful procedure. If I am on any medication for depression or any other mood-altering prescription, I will advise my technician.


I understand that the taking of before and after photographs of the said procedure are a condition of such procedure. I certify I have read and initialed the above paragraphs and have had explained to my understanding this consent and the procedure process. I accept full responsibility for the decision to have this cosmetic tattoo work done.


Treatment: Microblading / PMU Statement of Consent and Recitals: Please read and initial

Aftercare instructions have been explained to me and a written copy has been given to me to retain in my possession, which I will follow to the best of my ability. If I have questions, I will call or email you.

I understand that a certain amount of discomfort is associated with this procedure, and that swelling, redness and bruising may occur.

I understand that RetinA, Renova, Alpha Hydroxy and Glycolic Acids must not be used on treated areas. They will alter the color and cause premature exfoliation of the pigment.

I understand that tanning beds, pools, some skin care products and medications can affect my permanent makeup.

I understand that successful color saturation can NOT be guaranteed.

I understand that successful color saturation can NOT be guaranteed due to hidden scar tissue from a previous tattoo or scar.

I will tell all skin care professionals or medical personnel about my permanent makeup procedures, especially if I am scheduled for an MRI.

I accept the responsibility to explain to you my desire for specific colors, shape, and position for any procedure done today.

I understand that implanted pigment color can slightly change or fade over time due to circumstances beyond your control, and I will need to maintain the color with future applications and a touch-up session within 60 days.

I acknowledge that the proposed procedures(s) involve risks inherent in the procedure, and have possibilities of complications during and/or following the procedures such as: infection, misplaced pigment, poor color retention and hyper-pigmentation.

I have been advised that a touch-up session is highly recommended to make any adjustments to shape, color, and to fill any pigment that may have had poor retention. Touch-ups must be completed within 60 days of initial procedure.

I understand that it is my responsibility to book my touch up appointment in the allotted time frame (5-10 weeks) following my first treatment or else I will be charged a fee for the touch up. It is my responsibility to book in advance since Brows by T Marie, LLC, books up quickly and I will be charged if my touch up is 10+ weeks post first session due to trying to book last minute.

I have been quoted the cost of today’s appointment, and the cost of the touch-up. Touch-ups must be completed within 60 days of initial procedure or an additional cost may apply.

All information gathered from the client that is personal medical information and that is subject to the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) or similar state laws shall be maintained or disposed of in compliance with those provisions.

I have truthfully represented to the Technician that I am 18 years of age or older. I am not under the influence of any drugs or alcohol. To my knowledge, I do not have any physical, mental, or medical impairment or disability that might affect my well-being as a direct or indirect result of my decision to have a tattoo at this time.

I understand I will have permanent make-up applied using appropriate instruments and sterilization techniques. I understand that the permanent make-up site usually takes 2 weeks or longer to heal. I agree to release and forever discharge, and hold harmless, the Technician, all employees, contractors, and the management of the permanent make-up studio from any and all claims of negligence, damages, or legal actions arising from or connected in any way with my tattoo, the procedure, and conduct used in my tattoo and assume all responsibility for the decision(s) made consenting to this permanent procedure.

I am aware that tattoo inks, dyes, and pigments have not been approved the federal Food and Drug Administration and that the health consequences of using these products are unknown.

I am not pregnant or nursing. I do not have any history of herpes infection at the proposed procedure site. I do not have epilepsy, diabetes, allergic reaction to latex or antibiotics, hemophilia or other bleeding disorder. I do not have cardiac valve disease or suffer from any heart conditions or take medications that thins my blood.

If I suffer from hepatitis, or other risk factors for bloodborne pathogen exposure, or any other communicable disease, I have informed the Technician of the fact and have been advised of any medications and procedure necessary to promote the satisfactory healing of my tattoo.

I do not suffer from any medical or skin condition(s) such as, but not limited to: keloid or hypertrophic scarring, psoriasis at the site of the permanent make-up, or any open wounds or lesions at the site of the tattoo. I do not have a history of medication use or currently using medication, including being prescribed antibiotics prior to dental or surgical procedures.

I have advised the Technician of any allergies to latex gloves, soaps, or medications. I acknowledge it is not reasonably possible for the Technician to determine whether I might have allergic reaction to the permanent make-up process and further acknowledge that such reaction is possible.

I have read and understand ALL of the statements above.


I certify that I have read or have had read to me the contents of this form. I understand the risks and alternatives involved in this procedure(s). I have had the opportunity to ask questions, and all of my questions have been answered. I acknowledge that I have reviewed and approved the material given to me, and I authorize T MARIE PMU, LLC - Tiana Sayad, as my eyebrow microblading technician to perform on my body the Microblading/3D Eyebrow Embroidery procedure desired today.







First Client's Name
First Name*
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
First Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Second Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Tenth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
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*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
Photography Release Consent- *We would like your permission to use these photos for advertising or marketing purposes. Your name will not be used and/or affiliated with the photos posted. Your consent is necessary regarding this. Please indicate that you understand your before and after procedure photos may be used for advertising/marketing purposes online and otherwise.*

Client Medical History Form- Do you have or previously had any of the following: 

Have you received the COVID-19 vaccine within the last 2 weeks? Note: Appointment must be scheduled 2 weeks after/before 2 weeks of receiving the vaccine.*
No
Yes
Have you had previous work done to your eyebrows? (ie. tattooing, microblading, etc... NOT done by Tiana herself)*
No: I understand that if I neglect to inform my technician of previous brow work (Microblading/tattooing/etc) that my appointment will be cancelled and I will be charged a $100 salon fee.
Yes: NOTE- Please send clear photos of eyebrows with no make-up in natural lighting to browsbytmarie@gmail.com or 720-924-2315. Photos need to be sent within 48 hours of booking your appointment. An in person consultation may be required.
History of MRSA*
No
Yes
Diabetes ----(Microblading causes small shallow wounds on the skin, the healing of which will be complicated if your blood sugar is high. People with uncontrolled diabetes have poor wound healing because there is less oxygen supply to the tissues and fewer blood vessels. Aside from this, elevated blood sugar makes you prone to infection, because it lowers your immune system. - Please consult your doctor prior to booking)*
No
Yes
Are you Anemic / Do you have low iron levels? --- Due to elements present in permanent make-up pigments, individuals that have low levels of iron will physically not retain pigment.*
No
Yes
Forehead/Brow Lift*
No
Yes
Tan by booth or salon*
No
Yes
Take medication before dental work*
No
Yes
Pregnant now --- If Yes, you will need to wait to make an appointment until after pregnancy is complete and/or breastfeeding has come to an end.*
No
Yes
Brow Tinting --- Please do not tint brows for 3 weeks prior to appointment.*
No
Yes
Oily Skin (severely oily) --- it is recommended to book a Combination Brow service for optimal results.*
No
Yes
Have you ever been on/or currently on Accutane or any other acne treatment?*
No
Yes
Chemotherapy/ Radiation --- Must wait 6 months AFTER treatment*
No
Yes
Difficulty numbing with dental work*
No
Yes
Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc --- Must stop use of the above medications one week prior to Microblading.*
No
Yes
Botox*
No
Yes
Last treatment:
Hepatitis A B C D*
No
Yes
Easy Bleeding*
No
Yes
Facelift*
No
Yes
Abnormal Heart Condition*
No
Yes
Chemical Peel*
No
Yes
Last Treatment:
Breastfeeding now*
No
Yes
Autoimmune disorder*
No
Yes
Cancer*
No
Yes
Tumors/ Growth/ Cysts*
No
Yes
Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc*
No
Yes
Allergies to metals, food, etc*
No
Yes
Any diseases or disorders not listed*
No
Yes
Do you use skin care products containing Retinm A, Glycolic Acid, or Alpha Hydroxyl? --- Must stop use on forehead/brow area one week prior to appointment.*
No
Yes
*****Please list any medications you are taking:

I agree that all the above information is true and accurate to the best of my knowledge 

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.


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