Tiny Tattoo Consent Form

First Name *

Last Name *

Date of birth

Drivers License Number

Email *

Phone *

Have you taken any medications in the last 6 months? If yes, please list below. If no, input “N/A”. *

If you said yes or have experienced any other allergic reactions, please explain below. If none of these are applicable, please input N/A. *

Please be thorough in listing any additional medications, supplements, allergies, diseases, and medical history. If you have no further information, please input “N/A”. *

Which area(s) would you like your tattoo placed? If area is unknown, the artist can help you decide. *

IMPORTANT INFORMATION PRIOR TO SCHEDULING YOUR APPOINTMENT

PLEASE DELAY YOUR APPOINTMENT IF:

-You are pregnant or breastfeeding

-You have had any chemotherapy treatments. You must wait 6 MONTHS after your last treatment before getting this service done.

-You are on Accutane or any other oral acne medication. You must be off the medication for the SAME amount of time you were on it.

AFTER BOOKING APPOINTMENT:

If you are requesting a custom tiny tattoo design, please be sure to email your requests to [email protected] or message @enhancedbeautybarpgh on Instagram at least 1 week prior to appointment date

48 HOURS PRIOR:

-Do not consume any alcohol

-Do not take any aspirin, ibuprofen, or any pain relieving medications

ONE WEEK PRIOR:

Do not take any form of blood thinners including Fish Oil and Vitamin E

PLEASE READ AND SIGN BELOW

If an unforeseen condition arises in the course of my tiny tattoo, I authorize my Artist to use his/her professional judgment to decide how to proceed. I accept the responsibility for undergoing the Procedure. I understand that Enhanced Beauty Bar does not guarantee that I will not develop an allergic reaction to any products used on me. I understand if I develop an infection Enhanced Beauty Bar is not responsible for this. I understand this service may require additional sessions at an additional cost to achieve results desired. I have been informed that the highest standards of hygiene are met and that sterile, disposable needles and pigment containers are used for each individual client, procedure and visit. I give full consent to undergo the tiny tattoo with Enhanced Beauty Bar and accept any possible outcome that may occur.

PLEASE READ AND SIGN BELOW

Swelling, redness and bruising can occur following your procedure. Each person's body is different and therefore Enhanced Beauty Bar does not take responsibility if you do not achieve the results you desire. Of course we will do everything to ensure your procedure is done correctly, and encourage good results but in the end can not make any guarantees. Enhanced Beauty Bar is not responsible if you do not like the outcome of the tiny tattoo you receive. This service is nonrefundable.

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 the procedure done at this time. I agree to follow all pre-procedure information given in this consent form, as well as the post-procedure after care instructions given to me by my Artist. I confirm that I have a copy of the post care details.

Being of sound mind and body, I hereby release any and all responsibility. I accept any and all responsibility myself for any consequences that might stem from my decision to have the tiny tattoo performed by my Artist.

I understand that it is a requirement for my Artist to take before and after photos to keep for documentation purposes and to use in a portfolio or for social media purposes. I consent to these photos being taken and utilized.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE CONSENT AND PROCEDURE INFORMATION GIVEN TO ME ON THESE FORMS; THAT THE EXPLANATIONS THEREIN REFERRED TO WERE MADE AND ACCEPT FULL RESPONSIBILITY FOR THESE AND/OR OTHER COMPLICATIONS WHICH MAY ARISE OR RESULT DURING OR FOLLOWING THE MICROBLADING/PMU PROCEDURE. I UNDERSTAND THIS PROCEDURE IS NONREFUNDABLE. I UNDERSTAND IF I AM NOT SATISFIED I CONSENTED TO THE PROCEDURE AND EVERY ASPECT OF THE PROCEDURE. THE TREATMENT IS PERFORMED AT MY REQUEST ACCORDING TO THIS CONSENT, PRE-PROCEDURE FORM AND POST-PROCEDURE GUIDELINES. I HEREBY AUTHORIZE MY ARTIST TO PERFORM THE ISR SERVICE ON ME.

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Date *

I Fully Understand and Consent to the Information Above *

Clear