Lash & Brow Tinting Informed Consent


Although every precaution will be made to ensure your safety and well-being before, during and after your tinting
application, please be aware of the possible risks below. By signing at the bottom of this page you agree that you understand and accept the risks associated with treatment.
I understand that tinting lashes or brows has some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging or burning, blurry vision and potentially blindness should the tint enter into the eye.
I understand that if the tinting agent, developer, or mixture of both accidentally comes into contact with my eye, my eye will be flushed with water and medical attention may be required.
I understand that some irritation, itching or burning may occur to the skin which comes in contact with the tinting agent.
I understand that there may be some residual dark staining left on the skin following the tinting process of either my lashes, brows or both. This will fade and go away within a short time.
I understand that, while every attempt will be made to provide me with my chosen color, everyone’s hair absorbs color differently and my final results may not be the color I initially wanted.
I understand that over the course of several weeks, the tint will gradually lighten and fade. Re-tinting will be required to keep the new color fresh. Most clients need to re-tint every 3-4 weeks.
I have read the above information. If I have any concerns, I will address these with my skin care therapist. I give permission to my therapist
to perform the tinting procedure we have discussed, and will hold him/her and his/her staff harmless from any liability that may result from
this treatment. I have accurately answered the questions above, including all known allergies, prescription drugs, or products I am currently
ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as
possible. In the event I may have additional questions or concerns regarding my treatment, I will consult the esthetician immediately. I agree
that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully
understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand
the procedure and accept the risks. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions
that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

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Signature Certificate
Document name: Lash & Brow Tinting Informed Consent
lock iconUnique Document ID: 2976fe509a7415e5dc109b082f7deb2acd45a765
Timestamp Audit
July 13, 2022 9:15 pm EDTLash & Brow Tinting Informed Consent Uploaded by Brandi Bovell - cfomhs@gmail.com IP 98.117.94.236, 185.93.229.2, 127.0.0.1, 184.168.224.88, 0.0.0.0, 98.117.94.236
July 29, 2022 2:08 pm EDT Document owner cfomhs@gmail.com has handed over this document to Brandi@oldmechanicsvillehealthspa.com 2022-07-29 14:08:47 - 98.117.94.236, 185.93.229.2, 127.0.0.1, 184.168.224.88, 0.0.0.0, 98.117.94.236