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AFTERCARE
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
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PROCEDURE CONSENT
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COVID-19 WAIVER
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
PRE-INSTRUCTIONS CONSENTS
REVIEW THE FOLLOWING STATEMENTS AND INTIAL TO VERIFY YOUR UNDERSTANDING.
ANY MICROBLADING/MICROSHADING/NANO OR PERMANENT COSMETICS PROCEDURES MAY REQUIRE MULTIPLE TREATMENT SESSIONS. FOR BEST RESULTS, CLIENTS WILL BE ADVISED TO RETURN FOR AT LEAST ONE RETOUCH, TO ACHIEVE THE BEST RESULTS. RETOUCHES TAKE PLACE 4 TO 8 WEEKS AFTER THE INTIAL PROCEDURE.
PLEASE BE AWARE THAT THE COLOR INTENSITY WILL BE SIGNIFICANTLY DARKER AND THE SHAPE SHARPER IMMEDIATELY FOLLOWING THE PROCEDURE. THE COLOR WILL LIGHTEN BY %40-%50.
ALTHOUGH NUMBING CREAM IS USED DURING THE PROCEDURE, SLIGHT SENSITIVITY/DISCOMFORT MAY STILL BE FELT BY CLIENTS WITH SENSITIVE SKIN.
DELICATE AND/OR SENSITVE SKIN MAY BE RED AND/OR SWOLLEN AFTER THE PROCEDURE.
PREGNANT AND/OR NURSING WOMEN
CAN NOT
HAVE ANY PERMANANT COSMETIC SERVICES.
PLEASE
DO NOT
DRINK ALCHOL THE NIGHT PRIOR TO YOUR PROCEDURE.
REFRAIN FROM CONSUMING IBUPROFEN AND/OR ALEVE (NSAIDs), 24 HOURS PRIOR TO YOUR PROCEDURE.
ANY BROW WAXING SHOULD BE PERFORMED AT LEAST
48 HOURS
PRIOR TO THE PROCEDURE.
AHA PREPARTIONS MUST BE DONE NO LESS THAN
TWO WEEKS PRIOR
TO THE NANO BROW PROCEDURE. CHEMICAL, LASER AND/OR RETIN-A SHOULD NOT BE USED FOR
6 WEEKS
PRIOR TO THE PROCEDURE.
AVOID THE FOLLOWING HERBS AND SPICES PRIOR TO YOUR APPOINTMENT: BLACK PEPPER, CARDAMON, ANY MEMBER OF THE ZINGIBEROSIDE (GINGER), CAYENNE PEPPER, CINNAMON, GARLIC, GINGER, HORSERADISH AND MUSTARD.
I CERTIFY, THAT I HAVE READ AND INITIALED THE STATEMENTS ABOVE. I FULLY CONSENT AND ACCEPT RESPONSIBILITY FOR THE DECISION TO UNDERGO THIS SERVICE, AND GIVE MY PERMISSION A DAY IN PARIS, LLC. TO COMPLETE THIS SERVICE.
Name
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TOPICAL ANESTHETIC ADVICE AND CONSENT
REVIEW THE FOLLOWING STATEMENTS AND INTIAL TO VERIFY YOUR UNDERSTANDING.
ALLERGIC REACTION
: Can occur from any anesthetics used during the procedure. If you suffer from an allergic reaction, you should contact your doctor immediately. Symptoms of an allergic reaction may include: redness, swelling, rash, blistering, dryness or any other symptoms that may accompany an allergic reaction. If this occurs during the service, the provider will immediately stop the service and topically remove the anesthetic. PRIOR to your service please le your provider know if you have ANY allergies.
NUMBNESS:
We do not accept responsibility, if the area being treated does not respond to the numbing cream. Everyone's skin and skin type are different, therefore we cannot guarantee that the anethetic will effectively numb the skin. Some clients report complete numbness, while other may experience mild to moderate discomfort.
PROCEDURE
: For PMU procedures a numbing cream/gel is used. The products are formulated to be perfectly safe and can be purchased over the counter from any pharmacy/chemist. The anesthetic is placed over the treatment area for 20-30 minutes, then are carefully removed prior to treatment. As a result of the treatment, combined with the use of the anesthetic, you can expect to experience some redness/swelling that can last 1-4 days. You should always follow your Post Procedure/Aftercare advice to ensure the best results.
I understand, that the numbing creams/gels may be harmful to unborn babies. For this reason, UNDER NO CIRCUMSTANCE will we perform ANY semi-permanent cosmetic services on pregnant or potentially pregnant women.
I agree to refrain from any BOTOX treatment for at least
2-3 weeks
prior and/or
2-3 weeks
following any semi-permanent cosmetic brow treatments.
I certify and consent that I have read, signed and understand the statements above. I fully accept the responsibility for the decision to have this service done and give permission to my cosmetic professional to complete this service.
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RISK ACKNOWLEDGEMENT
This document will describe the possible side effects associated with semi-permanent cosmetics. Please review the following information and sign to certify that you have read, understand and agree to the statements in this form.
Nano brows and Microblading are semi-permanent methods of cosmetic tattooing using PMU equipment. Re-touch procedures may be necessary. A healing period of
4-6 weeks
is required before a touch-up may be performed. On rare occasions, the pigment may migrate under the skin. This procedure may be mild to moderately uncomfortable. Pain levels vary greatly from client to client. The pigments used in this service will fade. Immediately following the procedure, the pigment will appear
30-50%
darker than the healed result. Although extremely rare, some clients may experience an immediate and/or delayed allergic reaction to the pigments. A negative patch test does not guarantee that you will not develop an allergic reaction after the procedure. Allergic reactions to anesthesia can occur. Permanent cosmetics of any kind
CAN NOT
be applied to pregnant, potentially pregnant and/or nursing mothers. Permanent cosmetics
CAN NOT
be applied to anyone under the age of 18. Infections can occur if the aftercare instructions are not followed correctly. There may be swelling and redness following the procedure. You may experience some minor bleeding. If you have an MRI scan within
3 months
after the microblading procedure, you should notify/discuss:
HEALING PROCESS
The healing process will last a full six weeks, you will go through many stages. Initially following the service, you may have some redness and swelling, these should subside in
24-36 hours
.
Week 1
the brow pigments will oxidize and appear darker and more intense in color, than the healed result.
Week 2
of healing is when the brows will scab. During this time it is imperative that you
DO NOT PICK THE SCABS. Week 3
of healing, the scabs will fall off and the brows will begin to look light in color. Pigment will return to the skin gradually and be fully healed in 6 weeks.
1ST HOUR: Pat the area repeatedly with a CLEAN tissue.
(Only if needed to absorb lymph)
DAY 3 :
Start applying your
Aftercare Balm once daily
or as directed by your technician.
SHINE BRIGHT:
Avoid
DIRECT sunlight and tanning
for 2 weeks.
HANDS OFF: DO NOT
pick at your scabs.
STAY DRY:
Avoid
STEAM
. Avoid steam rooms, hot steamy showers, swimming and/or excessive sweating.
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INSTRUCTIONS, ANESTHETICS & RISK ACKNOWLEDGEMENT
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AFTERCARE
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
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PROCEDURE CONSENT
05
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COVID-19 WAIVER
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
EYEBROW TATTOO AFTERCARE
This document will provide the necessary information to care for your new semi-permanent brow tattoo. This information is meant to serve as a guideline, but does not guarantee results. Each person's skin responds and heals differently. Healing time, color, retention, touchups required and/or scarring will vary depending on the client.
WHAT TO EXPECT
You may experience discomfort, mild pain/sensitivity, swelling and/or redness following the procedure. The initial sensation will feel like a sunburn. The initial symptoms should subside within
1-3 days
. Avoid the sun heavy exercise/sweating, direct contact and excessive moisture for the first
10 days
following the procedure.
DAYS 1-3
Initially, the treated areas will appear darker, bolder, and more defined than the healed result. Please be aware of this and do no worry, as the final appearance will soften after the healing process is finished.
DAYS 4-10
Around day 4 or 5, your brows will begin to scab and flake.
DO NOT
scratch or pick at the scabs. Please note that picking, scratching or removing healing skin from your tattoo may result in loss of pigmentation. The scabs will fall off on their own and any needed corrections can be made during the touchup.
CARE INSTRUCTIONS
DO NOT
apply
ANY
makeup or products to your brows. Use only the
Aftercare Balm and Wash
until your brows are completely healed.
DAYS 1-9:
Using a small amount of antibacterial soap on your fingertips, gently cleanse your brows at the
beginning
and
end
of each day. Use a gentle patting motion,
DO NOT
rub. Blot gently to dry, once dry apply Aftercare Balm.
DO NOT
apply Aftercare Balm more than twice a da, to avoid clogging and premature flaking.
DAYS 10-14
Once the scabbing process is completed, you may resume regular exercise, sun exposure and wetting at your own discretion. Continue to
AVOID
chemical peels, exfoliating and/or using products that contain retinol, AHA's and/or glycolic acids until after your healed touchup.
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INSTRUCTIONS, ANESTHETICS & RISK ACKNOWLEDGEMENT
02
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AFTERCARE
03
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
04
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PROCEDURE CONSENT
05
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COVID-19 WAIVER
06
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
PHOTO AND VIDEO CONSENT
This document is to request your permission to take photos/videos of you and the treated areas before and/or after the procedure(s). These photos may be used for advertising, marketing, portfolios, training and/or other uses. Your consent is necessary in order to proceed with using said photos.
Select one of the following options, regarding your consent for the use of photos/videos from your procedure:
YES, you may use photos/videos of me and my treated areas.
NO, you may NOT use photos/videos of me.
DEPOSITS AND PAYMENTS
Deposits are required for ALL services. These deposits are NON-REFUNDABLE. We require a 24-hour notice for rescheduling or cancellations. The client will forfeit their deposit if the proper notice is not given in the allotted time frame. Deposits are transferrable to new appointments or services if the original appointment must be canceled. Should you need to reschedule for a 3rd time, a new deposit will be required.
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INSTRUCTIONS, ANESTHETICS & RISK ACKNOWLEDGEMENT
02
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AFTERCARE
03
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
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PROCEDURE CONSENT
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COVID-19 WAIVER
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
PROCEDURE CONSENT
R
EVIEW THE FOLLOWING STATEMENT AND SIGN TO VERIFY YOUR UNDERSTANDING AND CONSENT.
The result of the procedure is determined by the following: medication, skin characteristics (dry, oily, sun-damaged, thick or thin skin types), personal pH balance of your skin, alcohol intake and smoking, post procedure after care. Upon completion of the procedure there might be swelling and redness in the effected area, which will subside in 1-4 days. In some cases, bruising may occur. You may resume regular activities following the procedure, however, using cosmetics, excessive perspiration and exposure to the sun must be limited until the skin has fully healed. Please refer to the aftercare card for more information. I have been advised that the true color will be seen 1 month after each procedure. The pigment may vary according to skin tones, skin type, age and/or skin condition. I understand that some skin types accept pigment more readily than others, therefore, we can not guarantee the result of this procedure. To my knowledge, I do not have ANY physical, mental or medical impairment/disability that may affect my wellbeing as a direct or indirect result of my decision to undergo this procedure. I agree to follow ALL pre and post-procedure instructions, as provided and explained to me by my technician. I can confirm that I have received a copy of aftercare details. Being of sound mind and body, I hereby release and accept any and all risk and responsibilities associated with this procedure. I have read and understand the contents of this waiver. I accept any and all responsibility, for any consequences that may result from my decision to have any permanent cosmetics performed by a member of A Day in Paris, LLC. I agree, understand and accept the terms of this waiver.
Signature
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INSTRUCTIONS, ANESTHETICS & RISK ACKNOWLEDGEMENT
02
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AFTERCARE
03
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
04
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PROCEDURE CONSENT
05
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COVID-19 WAIVER
06
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
COVID-19 LIABILITY AND RELEASE WIAVER
Name
The World Health Organization has declared the novel Coronavirus (COVID-19) a global pandemic. The government has set recommendations, guidelines, and prohibitions due to the the transmissibility of the virus. Please review to the following and sign this waiver to verify your understanding and agreement to the following disclosures.
REVIEW THE FOLLOWING STATEMENTS AND INITIAL TO VERIFY YOUR UNDERSTANDING.
I have NOT experienced symptoms of fever, fatigue, coughing, difficulty breathing and/or any other sympotms related to COVID-19 within the last 14 days.
I, as well as all members of my household, have NOT traveled internationally or visited any areas highly affected by COVID-19 within the past 30 days.
I, as well as ALL members of my household, have not been diagnosed or tested positive for COVID-19 within the past 30 days.
I, as well as ALL members of my household, have not knowingly been exposed to any individuals who were diagnosed or tested positive for COVID-19 within the past 30 days.
I understand the risks involved and hereby, release, waive and discharge A Day in Paris, LLC., its board officers, independent contractors, affiliates, employees, representatives, successors and assigns from any and all liabilities, responsibilities, claims, demands, and/or any and all actions, that may result from any kind of loss, damage, injury or death, sustained by me or those I may infect with COVID-19 due to my willing participation while in, on, or around the premises or while using the facilities, that may lead to unintentional exposure or harm due to COVID-19.
I CERTIFY THAT I HAVE READ, ACKNOWLEDGED, AND INITIALED THAT STATEMENTS ABOVE TO THE BEST OF MY KNOWLEGE. I VERIFY THAT I HAVE BEEN ADEQUATELY INFORMED OF THE RISKS ASSOCIATED WITH COVID-19 AND CONSENT TO RECEIVE THIS SERVICE. I FULLY ACCEPT RESPONSIBILITY FOR MY DECISION TO HAVE THIS PROCEDURE COMPLETED.
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01
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INSTRUCTIONS, ANESTHETICS & RISK ACKNOWLEDGEMENT
02
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AFTERCARE
03
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PHOTO/VIDEO CONSENT & DEPOSIT/PAYMENT AGREEMENT
04
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PROCEDURE CONSENT
05
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COVID-19 WAIVER
06
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UNDERAGE CONSENT
A DAY IN PARIS
NANO BROWS WAIVER
I am the natural parent or legal guardian of:
The minor child's date of birth is:
MM
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The child's age is:
I have the legal authority to consent to this child's tattoo. (Please initial)
I consent to the tattooing of my child as follows (describe the tattoo and its location on the body):
Print Name:
Signature
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Date
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SUBMIT FORM
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