Health Condition Questionnaire In order to perform the your service(s) in a safe manner, please answer the following health questions accurately.
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Do you suffer from the following disease or are you taking any of these medications?
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Please elaborate below if yes:
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Please elaborate below if yes:
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Please elaborate below if yes:
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Please elaborate below if yes:
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What skin care products do you use daily?
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Please elaborate below:
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Please elaborate below if yes:
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Please elaborate below if yes:
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Physician’s name:
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This information is confidential and it shall also be handled that way. Tint Brow Studio assumes no liability in case of giving false information.
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Disclaimer There is a possibility of an allergic reaction to pigments. A patch test is advisable however it does not ensure a client will not have an allergic reaction. If you would like the patch test, we will test a small area and then you will come back on a different day to complete your full appointment.
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Patch Test Consent: |
I waive the patch test |
I would like a patch test |
If waived, I release the technician from liability if I develop an allergic reaction to the pigment.
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