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Babyface Brows Release Form

Our objective at Babyface Brows is to help you achieve beautiful and natural eyebrows. Our Semipermanent Eyebrows are customized for you and your hair type, skin type and skin tone. Your health, safety and comfort are of our greatest concern.

Please be aware of the following:

This form is designed to give information needed to make an informed decision of whether or not to undergo permanent cosmetics application. If you have questions, please don't hesitate to ask.

This is the process of inserting pigment into the dermal layer of the skin, and is a form of tattooing. Be advised that this procedure involves a single-use needle that is disposable and sterile. 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 strictly adhered to.

Please be advised that a certain amount of discomfort is associated with this procedure. There are occasions where individuals may experience swelling, redness, itching, scabbing, light bruising and tightness. If this occurs, using an ice pack may provide relief. If severe reaction occurs, contact a physician.

Although permanent cosmetic tattooing is effective in most cases, guarantees can't be made that a specific client will benefit from the procedure. Generally, the results are excellent, however, a perfect result is not a realistic expectation.

Initially, the color will appear much more vibrant or darker compared to the end result. Usually within 30 days, the color will fade 30-40%, soften and look more natural. The pigment is permanent but will fade somewhat overtime and will likely need to be touched up throughout the years.

Your Semipermanent Eyebrows should last 18-24 months, depending on your pre and post-care regimen. It's very important to follow care instructions after application and avoid long baths or showers and hot tubs. Salt water exposure or a chlorinated pool can also shorten the lifespan of your eyebrows. Following the session, please avoid using any makeup near the procedure area, excessive perspiring, and sun exposure for at least 10 days.

I have read the contents of this consent form carefully and state that I authorize Babyface Brows and all technicians to perform permanent cosmetics applications. I am not aware of any medical condition, allergies, or other reason that would prohibit me from permanent cosmetics application. I have been given adequate information of this procedure(s), understand the risks involved, and allow it to be performed at my own risk. I have been advised to contact a physician if any adverse reaction occurs.

I do here and forever release, discharge, and hereby hold harmless Babyface Brows and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action, or cause of action, present or future, arising out of or connected with my participation in this activity, including any injuries resulting there from. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this activity. I understand that results may vary.



First Client's Name
First Name*
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Client Medical History - Do you presently have or previously had any of the following?
Diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, tuberculosis or any contagious diseases*
No
Yes
Abnormal heart condition*
No
Yes
Please list any diseases or disorders not listed above that you have:
Any skin conditions we should be aware of? *
None
Eczema
Psoriasis
Easy bleeding
Keloid scarring
Other
Are you currently experiencing alcoholism?*
No
Yes
Are you vegan?*
No
Yes
Have you had any of the following procedures or surgeries performed within 1 year? *
No
Blepharoplasty (eyelid surgery)
Corneal abrasion
Brow or face lift
Other (surgery in the eye or eyebrow region)
Brow waxing done within the last 3 days?*
No
Yes
Difficulty numbing with dental work*
No
Yes
Allergies to ingredients in numbing agents such as alcohol, Lidocaine, Prilocaine, Benzocaine, Tetracaine, or Epinephrine*
No
Yes
Are you allergic to any cosmetic ingredients, nuts, metals, or dyes?*
No
Yes
If so, what are you allergic to that we should be aware of? Please let us know 24 hours prior to your appointment if you have any allergies of concern.
Do you use skincare products containing: *
None
Retinol
AHAs/BHAs
Taking any blood thinners: *
None
Aspirin
Ibuprofen
Alcohol
Other (ie: prescription blood thinner)
Please list any medications or vitamins you are presently taking:
Anything else you would like to make us aware of prior to your session?
Possible Risks, Hazards, or Complications

Pain: There can be discomfort even after the topical anesthetic has been used. Anesthetics work better on some individuals than others.

Infection: Infection is very unusual. The areas treated must be kept clean and only freshly cleaned hands should touch the area. See "After Care" email for instructions 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 correct any unevenness.

Excessive swelling or bruising: Some people bruise and swell more than others. Ice packs may help and the bruising and swelling typically disappears within 1-5 days. Some people don't bruise or swell at all.

MRI: Because pigments used in permanent cosmetic procedures contain inert oxides, a low level magnet may be required if you need to be scanned by an MRI machine. You must inform your technician of any tattoos or permanent cosmetics.

The alternative to these possibilities is to use cosmetics and not undergo the Permanent Cosmetics procedure.



I have read and understand all of the above possible risks, hazards, and complications.
I will tell all skincare professionals or medical personnel about my permanent makeup procedures, especially if I'm scheduled for an MRI.
Important Post Procedure Instructions

Aftercare is very important for producing a beautiful and lasting result.

Healing takes approximately 10 days. During this time:

  • Avoid sun exposure. Wear a hat for physical sun protection. After the 10 days, always use a sun block to protect from sun fading.
  • Avoid submersion in water and high humidity activities (pools, saunas, facials, massages).
  • Keep the area clean by washing with the provided soap. Splash with water and pat dry with paper towel.
  • Apply a very light coat of the aftercare balm with freshly washed hands or a Q-tip immediately after patting the eyebrows dry.
  • Do not scrub, rub or pick at the epithelial crust that forms. Allow it to flake off by itself. If it is removed before it's ready, the pigment underneath it can be pulled out
  • Do not use any makeup near the procedure area for at least 10 days. Purchase new makeup if possible to avoid contamination or bacterial infection.
  • Do not apply any skincare products directly on your eyebrows (only use the enclosed products in your care kit
  • Understand that Retin-A, Renova, Alpha Hydroxy, and Glycolic Acids must not be used on the treated areas. They will alter the color

Failure to follow aftercare instructions may result in infection, pigment loss or discoloration.


What's normal immediately after the procedure?

Bold/dark eyebrows and slightly uneven appearance. After 2-7 days, the darkness will fade and once swelling dissipates, any unevenness usually disappears. If they are still a bit uneven after 4 weeks, then we will make adjustments during the touch up appointment.

Color change or color loss. As a procedure area heals, the color will lighten and sometimes seem to disappear. This can 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 at least 4 weeks.

Needing a touch up months or years later. A touch up may be needed 1-5 years after the initial procedure depending on your skin, medications and sun exposure. We recommend a touch up 1-6 months after the first session (current rate valid if you book within the time frame - this is your responsibility) and every few years to keep them looking fresh and beautiful.



I have read and understand all of the post care instructions.
I understand that written instructions on how to care for my tattoo will be given to me, which I will follow to the best of my ability. If I have any questions, I will call, text or e-mail a Babyface Brows agent.
I understand that sun, tanning beds, pools, some skincare products and medications can affect my permanent makeup.
Statement of Consent and Recitals

Please read and check boxes:

I accept the responsibility for explaining to my technician 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 my technician's control and I will need to maintain the color with future touchup applications.
I realize that there is potential for discomfort during the procedure and during the healing process, including the possibility of bleeding, swelling, and allergic reaction to pigments. I also understand that misplacement of the pigment can occur under rare circumstances, and that a cosmetic tattoo can only be removed with surgical procedure or laser procedures, and that any affective removal may leave permanent scarring or disfigurement.
I do not have a heart condition or take medication that thins the blood. I also have informed my technician of medications being taken by me, including but not limited to Retin-A and Accutane (these medications will affect the tattoo application and healing process).
I am not pregnant or nursing, nor am I under the influence of drugs or alcohol.
I have reviewed the FAQ section on babyfacebrows.com prior to my appointment, and understand the information and policies addressed here. I understand my responsibility to advise my technician of ANY concerns I may have before the procedure has begun, and I believe that I have sufficient information to give consent.
I have been quoted the cost of today's appointment.
I have read the contents of this consent form carefully and state that I authorize Babyface Brows and all technicians to perform permanent cosmetics applications. I am not aware of any medical condition, allergies, or other reason that would prohibit me from permanent cosmetics application. I have been given adequate information of this procedure(s), understand the risks involved, and allow it to be performed at my own risk. I have been advised to contact a physician if any adverse reaction occurs.
I do here and forever release, discharge, and hereby hold harmless Babyface Brows and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action, or cause of action, present or future, arising out of or connected with my participation in this activity, including any injuries resulting there from. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this activity. I understand that results may vary.
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 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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