Photograph and Publicity Release Form I, "Client" give my permission to use my image, appearance as such may be embodied in any pictures, photos, video recordings, digital images, and testimonials, re- views taken or made on behalf of G.k Micro Artistry. I agree that G.k Micro Artistry has com- plete ownership of such pictures , etc., including the entire copy right and may use them for illus- tration, bulletins, exhibitions, video types, reprint, reproductions, publication, advertisement, and any promotion or educational in any medium now known or later developed, including the inter- net . I acknowledge that I will not receive any compensation for the use of such pictures. I hereby release G.k Micro Artistry from any and all claims which arise out of the use of any images used as stated above. I have read and understood this consent and release. I give my consent to G.k Micro Artistry to use my likeness to promote their company and or their activities I Agree CONSENT TO APPLICATION OF PERMANENT COSMETIC PROCEDURE Please initial each area highlighted after you have read these statements and agree with their content. I am over the age of 18, am not under the influence of drugs or alcohol, am not pregnant or nursing and desire to receive the indicated permanent cosmetic procedure(s). The general nature of cosmetic tattoo- ing as well as the specific procedure to be performed has been explained to me. I Agree PROCEDURE(s): EXPECTED NO. OF VISITS REQUIRED: COST OF PROCEDURE(s): I have been informed of the nature, risks, and possible complications and consequences of permanent cosmetics (permanent skin pigmentation/cosmetic tattoo). I understand the permanent cosmetic 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 permanent cosmetic procedure(s), and accept the perma- nence of the procedure, acknowledge the likelihood of fading over time, as well as the possible complica- tions and consequences of the said procedure(s). I Agree 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 Agree 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. I have disclosed all medications and/or drugs I am taking either prescription or non- prescription and their purpose or indications. I have disclosed any medical conditions that may affect the healing of my skin pigmentation I Agree I understand that the taking of before and after photographs of the said procedure(s) are a condition of such procedure(s).I Agree I understand that I will not hold G.K MICROARTISTRY accountable for any fading or retention of ink and that sometimes it could require multi- ple touch ups due to lifestyle or specific skin types or medication that can cause the skin not to heal correctly. I understand there is a No Refund Policy and any touch ups necessary will be a separate cost of price quoted. I certify I have read and initialed the above paragraphs and have had explained to my understanding this consent and procedure permit. I accept full responsibility for the decision to have this permanent cosmetic procedure(s) performed. PERMANENT COSMETICS
Be prepared for the color intensity of your procedure to be significantly sharper, brighter, or darker than what is expected for the final outcome. It will take time for this transition and is based up- on how quickly the outer layer of your skin exfoliates. While these tattooed colors may initially simulate the exact color and tone desired, they will not always remain a perfect match. Tattooed colors are constant, while your own skin color will vary depending on exposure to cold, heat, sun and circulatory changes. For example, if you tan your skin and had a scar cam- ouflaged, your surrounding skin will be darker in appearance than the treated area. - Since delicate skin or sensitive areas may swell slightly or redden, some clients feel it best not to make any social plans for a day or two following any procedure. It is always best to avoid these procedures within months prior to important life events such as weddings. Procedures may take longer than expected to be completed under some circumstances.
- Wear your normal makeup and bring your lip color or brow pencils to the office on the day of the procedure.
- Refrain from the use of alcohol, aspirin, aspirin-containing medications, ibuprofen, or other blood- thinning medications for seven days before and two days after any procedure. Refrain from judg- ment-altering drugs for at least 24 hours prior to any procedure. No medication should ever be discontinued without first consulting your physician.
- A skin test is offered upon request.
Practitioner makes no attempt to, or claim to, practice medicine. Some Individuals will have complications related to permanent make up application. These complications are usually mild and last only a few days. However, extreme complications are always a possibility. If you are healthy and there are no visible reason restriction you from receiving a tattoo, you must approve of the design and color before the application of your permanent makeup. I "agree" Approve of Mapped Shape & Color before starting and authorize and give full consent Gk Microartistry to perform permanent cosmetics. I do not hold Gk Microartistry accountable and agree to a No refund policy. Seek Medical help or see a physician if you experience symptoms such as excessive swelling, redness, yellow or green discharge, fever, or see streaks running towards the heart- which could indicate sign of an infection. CONSENT TO APPLICATION OF PERMANENT COSMETIC PROCEDURE I understand that the FDA has not approved of any: inks, dyes, or pigments and that health effects are unknown. I Agree
GK MICROARTISTRY PRIOR LIP PROCEDURE Thank you for booking your appointment for your semi permanent lip blush! Below are some notes to read prior to your appointment. If you have any questions, please do not hesitate to ask. BEFORE YOUR APPOINTMENT The appointment is divided into three parts: consultation/pre numbing, lip mapping, and the actual tattoo procedure. During the consultation, you would be able to decide exactly what lip color and minor changes to your lip shape. PLEASE NOTE: we will not be able to change your lip shape drastically to fix major asymmetry, as we cannot tattoo on facial skin. Facial skin and lip skin are very different and will take color very differently. You may bring in your favorite lipstick shade if you would like me to match that shade. I will map your lips based on your natural lip contours before starting the tattoo procedure. We would not start the procedure until you are 100% happy with the shape and color. I Agree Semi permanent makeup normally requires multiple sessions to perfect and complete your look. I recommend returning for a touch up session anywhere from 6-12 weeks after your initial appointment. Keep in mind, any touch up booked beyond the 12 weeks mark will include an additional cost. All permanent cosmetic procedures are multi-session processes in certain cases such as neutralization.[agree] Prior to your appointment: · You may do your makeup as normal. Please bring your makeup to your appointment to touch up prior to pictures. · Exfoliate daily for 7 days with a sugar scrub and keep lips well moisturized. Dry spots on lips will snag the needle. You can make a sugar scrub at home by mixing sugar with a few drops of coconut oil. · If you’re concerned about bruising or generally bruise easily, you can start homeopathic Arnica. Two Arnica tablets can be taken 3x a day for 5 days. You can start the day before and continue for 5 days following treatment. (Topical Arnica is not recommended) · To ensure pain tolerance and reduce bleeding: o Heighten pain is expected during menstrual cycle
o If desired, Tylenol may be taken prior to procedure. Aspirin and Ibuprofen are blood thinners, therefore should be avoided. · NO blood thinners medications: Advil, Aspirin, Motrin, ibuprofen, Niacin, Excedrin, Aleve 7 days prior and 1 day after. (PLEASE NOTE: Coumadin and Plavix have blood thinning effects but is not recommended to discontinue due to their medical necessity. Please consult with your physicians before discontinuing any medications for any chronic conditions.) · NO supplements with blood thinning effects: fish oil, dong quai, gingko, biloba, ginseng, red clover, and vitamin E for 7 days prior. · Absolutely NO alcohol or coffee 24 hours prior. They will increase your chances of bruising. · Clients who have had a cold sore in the past must be proactive to prevent a possible flare up post procedure. Please consult with your physician PRIOR to appointment. (Many clients have avoided a cold sore post procedure by taking Valtrex or L-lysine. YOU MUST CONSULT YOUR PHYSICIAN PRIOR TO APPOINTMENT PRIOR TO STARTING ANY MEDICATIONS.) · If your skin around the area we’re working on is comprised: break out, rash, inflamed, bruised, blemished; unfortunately we will have to reschedule. Please contact me prior to appointment to reschedule. · Avoid chemical peels, Retin-A, retinols, at least 4 weeks prior and after. · Those taking Accutane, antasure, and steroids must be off for a minimum of 6 months prior to treatment · If you intend on getting any botox or fillers around the treated area, please do so at least 2 weeks before. Fillers will actually help aid in the procedure. · Any facial cosmetic surgery should be done at least one year prior to procedure. · For my survivors, you must be in remission for at least 6 months prior to receiving any tattoo services Please note of the below disqualifications: • Anyone with the following conditions will absolutely not be allowed to receive any treatment.
o Expecting mothers and nursing mothers
o Under 18 years of age
o Active skin cancer in treated area
o Those who have experienced post inflammatory hyperpigmentation
o Those who have received radiation or chemotherapy within the past 48 days. o Those with any transmittable blood conditions: Hepatitis or HIV
o Those with skin diseases such as eczema, psoriasis on the treated area
o Those with shingles within the last 6 months. • Anyone with the following conditions will need a doctor’s note clearing them for the tattoo procedure before receiving any treatment. Doctors note need to be emailed to: magnoliainkct@gmail.com at least 7 days prior to appointment date or appointment slot will be cancelled with loss of deposit. o Diabetes
o Hemophiliac
o Healing disorders
o Thyroid disorders
o Hypertensive/ high blood pressure
o On long term blood thinning medication POLICY · A deposit is required to book any appointment. Deposit will be credited towards the total balance on the day of your appointment. Deposit must be sent within 48 hours to secure the appointment before the hold is lifted and appointment time is released back for others to book. · Deposits are NON REFUNDABLE and NON TRANSFERRABLE. · I understand things can come up. If you need to reschedule for any reason, please do so at least 3 days in advance. Please note, if you reschedule without at least 3 days notice, your deposit will be forfeited. Additional deposit will be required to reschedule. (Reschedules will be based on current availability.) o Any client who is sick, has a cold, flu, feeling ill, etc please contact me to reschedule. If you do come in sick, your appointment will be cancelled and deposit will be forfeited. § Since your immune system is already compromised, there is a high chance of healing complications, prolonged healing, loss of pigment, and increase risk of infections. · No shows will automatically forfeit their deposit and will not be allowed to reschedule. · If you are more than 2o minutes late, your appointment will be cancelled and your deposit will be forfeited. Additional deposit will be required to reschedule. (Reschedules will be based on current availability.) Being late will delay the rest of the day’s schedule and is unfair to other clients. Please be courteous to others. · No guests, kids, or pets allowed at the appointment to prevent cross contamination of the procedure area. · Cash, Zelle, and Apple Pay are accepted. Cash is preferred. · All major credit cards are accepted with a 3% transaction fee. · I DO NOT accept checks, apple pay, or any other payment apps. · For any clients with previous tattoos, please send a clear photo of your previous work, free of any makeup and/or filters. I would love to be ale to fix and correct all previous work. Unfortunately, that may not always be possible. If any clients come in with previous work without letting me know PRIOR, the appointment will be cancelled and result in lost of deposit. · Pre- care instructions are sent to every client following confirmation of their appointment. It is your responsibility to read and follow all instructions. If you have any questions regarding the instructions, please ask. Failure to do so will result in cancellation of your appointment. · We reserve the right to refuse service to anyone. · Prices are subject to change at any time. · We are not liable for any changes to shape and color clients wish to make once a final decision is made during the consultation. To ensure satisfaction, please carefully review drawn shape and color PRIOR to starting. Your satisfaction is important to us so please make sure you are happy with the chosen shape before consenting. Once consented, your look will be final. I have read pre care.AFTERCARE INSTRUCTIONS · Please keep in mind, your lip blush tattoo immediately is still considered a WOUND and should be treated and cared for as such. Wash hands thoroughly before touching lips. · Expect slight swelling, redness, and tenderness in the immediate area. It will subside within 24-48 hours. You may apply ice to help the swelling subside. Any bruising will subside within 24 hours. FOR THE FIRST TWO DAYS: · Treated area can only be cleansed using the provided wipes. The treated area should be cleaned 3x day: morning, afternoon, and evening. No water or other cleanser can be used for any reason. UNTIL ALL SCABS FALL OFF: · Wash with water and gentle soap. No rubbing or scrubbing. · Apply THIN layer of ointment on lips throughout the day. The key is to protect the wound and aid the healing with moisture. Keep lips moisturized at all times. Do not let the lips dry out. (If you experience swelling, rashes, blistering, or other complications post procedure, discontinue ointment. You may be allergic to the ointment.) · Apply thick layer only prior to shower and face cleansing. · Use minimal toothpaste and mouthwash. Excessive amount will cause pigment loss. · Rinse mouth with cool water after eating and reapply ointment. · Once lips crusts, scabs, and peels DO NOT pick or scratch. Picking and scratching can cause pigment loss. · No lipstick or lipgloss during healing to prevent infection. You may apply makeup once lips finish peeling. · Drink liquids with a straw. · Until scabs are fully gone avoid: contact with lips (including food/ cut food into small bite size pieces), spicy, salty food, alcohol, acidic food and liquids, excessive sweating, gym, sauna, pools, sunbathing, and teeth bleaching toothpaste. · Avoid Retin A, Glycolic Acids, Vitamin E, Terry Towels, Vitamin C (anything that promotion accelerated healing and cell turnover) during healing. · After lips have fully peeled, you are free to resume normal activities (working out, makeup, pools, etc.) · No contact with animals, or gardening for 7-10 days (until area is completely healed) post procedure and after all touch ups. · If you have excessive redness, swelling or tenderness or any red streaks going from the procedure site toward the heart, elevated temperature, or purulent drainage from the procedure site, contact you physician as the area may be infected and you may need to seek medical care. ONCE HEALED · Use sunscreen 35+ daily to prevent premature fading of brow pigments. · Any chemical peels, Retin A, microneedling on lips will lighten pigment. Use at your own discretion. · Any laser treatment is to be avoided directing surrounding and on eyebrows. Please inform your technicians of your tattoo prior to any laser treatments. STAGES of HEALING Immediately After, Day 1 Day 2 Day 3-6 Days 5-7 Week 2-8 After 8 weeks Expect slight swelling, redness, tenderness, and bruising. May apply ice to help swelling. Lips may still be swollen. Apply ointment as needed to keep lips moist at all times. Do NOT let lips dry out. Lips will start to crust and flake off. Do not scratch, rub, or pick at scabs. Again, do NOT let lips dry out. Scabs should be fully peeled and flaked off. It is common for the lips to appear extra light. Color will resurface as cells repair. Lip color will settle in and appear true to color. At this point, you may come back for a touch up. Any corrections can be adjusted at this time. Please be patient, the first session is to see how your skin responds to the pigment. Results vary per client based on a variety of factors. Any adjustments may be made during the touch up. I have read and will follow after care.
Client CHART NOTES: Needle size: PMU PIXL CARTRIDGES .30mm,.25mm,1RL,.30/.25mm 1rl .35mm (3RL).25 3RS lot # 012021,082022,052022 Supreme needle cartridges: .25 1RL, .25RLT,.30RLMT lot #211001 lot# 220101
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