Consent
This form provides information to assist in making an informed decision of whether or not to undergo a semi-permanent cosmetics application. If you have questions, please don‘t hesitate to ask.
Although permanent cosmetic tattooing is effective in most cases, no guarantee can be made that a specific client will benefit from the procedure. This is the process of depositing pigment into the top dermal layer of the skin and is a form of tattooing.
I will tell all skincare professionals or medical personnel about my permanent makeup procedures. I understand that any skin treatments i.e. Retin A, Renova, Alpha Hydroxy and Glycolic Acids, laser hair removal, plastic surgery, or other skin altering procedures may result in adverse changes to my permanent makeup. I understand that the sun, tanning beds, pools, some skincare products and medications can affect my permanent makeup.
I understand that successful colour saturation can NOT be guaranteed due to hidden scar tissue. I acknowledge that the proposed procedure(s) involve risks inherent in the procedure and have possibilities of complications during and/or following the procedures such as infection, poor colour retention and hyper-pigmentation.
I accept the responsibility of explaining to you my desire for specific colours, shape, and position for any procedure done today.
I understand that after my service, there will be no refunds. No exceptions.
All complimentary follow-up sessions that are must be done 6-9 weeks from the initial session. Failure to make this appointment will incur its corresponding fee.
I understand that implanted pigment colour can slightly change in colour or shape and fade over time due to circumstances beyond my artist control. I will need to maintain the colour with future applications at my own expense.
If I have any signs and symptoms of infections, I will seek medical care. These include but are not limited to redness, swelling, tenderness of the procedure site, red streak going from the procedure site towards the heart, elevated temperature, or purulent drainage from the procedure site.
RIGHT TO DISCONTINUE TREATMENT I understand that I have the right to discontinue treatment at any time & I understand payment will still have to be made in full.
PAYMENT I understand that this is an ‘elective’ procedure and that payment is my responsibility and is expected at the time of treatment.
PUBLICITY MATERIALS I authorise the taking of clinical photographs and videos. I understand that photographs and videos may be taken of me for educational and marketing purposes.
I acknowledge that this procedure may alter my appearance and that no representations have been made to me to remove my permanent makeup. To my knowledge, I do not have a physical, mental, medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have permanent makeup.
If a dispute arises out of or relates to this contract or the alleged breach thereof, and if the dispute is not settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation within 30 days administered under (name Rules) before resorting to arbitration, litigation, or some other dispute resolution procedure. If parties are unable to agree on a mediator, a mediator shall be appointed by the named administrator. The process shall be confidential based on terms acceptable to the mediator and/or mediation service provider.
I acknowledge it is not reasonably possible for my technician to determine whether I might have an ALLERGIC reaction to the pigments, anaesthetic or ointment used in this process. I agree to forego a patch test and accept the risk that such a reaction is possible.
Notice that tattoo inks, dyes, and pigments have not been approved by the federal Food and Drug Administration and that the health consequences of using these products are unknown. *
I understand the restrictions on physical activities such as bathing, recreational water activities, gardening, or contact with animals, and the duration of the restrictions.
Before you book
Please carefully read through ALL of our terms and conditions of booking before making an appointment. This page covers who can/cannot have micropigmentation treatments, booking information, clinic policy and our COVID-19 saftey protocols.
MICROPIGMENTATION TREATMENTS CAN NOT GO AHEAD FOR PEOPLE THAT ARE/SUFFER FROM ANY OF THE FOLLOWING:
- Pregnant/breastfeeding
- Keloid scarring
- High/Low blood pressure
- Problems with wound healing
- Diabetic
- Undergoing Chemotherapy/ Radiotherapy (must be 5 weeks post)
- Viral infections (diseases)
- Had botox/filler within a 2 week period of appointment (in the area to be treated)
- Heart problems
- Taking blood thinning medication
- Epilepsy/backouts
- Sick with a cold or flu-like virus
- Used Accutane or Rooaccutane in the last 6 months
- Have allergies to nickle or iron oxide
- Unrealistic expectations
IF YOU SUFFER FROM COLDSORES AND ARE LOOKING TO GET OUR LIP BLUSH TREATMENT YOU MUST GET A PRESCRIBED ANTI – VIRAL MEDICATION SUCH AS ACYCLOVIR FEW DAYS PRIOR TO YOUR APPOINTMENT BEFORE AND AFTER THE PROCEDURE TO PREVENT A BREAKOUT.
BOOKING
- Pin Aesthetics does not take deposits for treatments
- Appointments are FRIDAYS only at Home clinic.
- Please book through booking app https://pinaesthetics.book.app
- We request 24 hours notice for cancellations .
- In order to change the date/time of your appointment please follow the link and instructions that can be found in your confirmation e-mail.
CLINIC POLICY
- All clients must be over the age of 18
- Children are strictly not allowed in the clinic
- No food/drinks are allowed in the clinic due to hygiene reasons
GUARANTEE
- We offer NO GUARANTEE for micropigmenation results.
- Individual results will vary from client to client.
- Aftercare of your micropigmentation and your skin type will directly contribute to your final results.
- Some may require additional touch ups to achieve their desired results.
- Regular touch up pricing will apply.
COVID-19 REOPENING PROTOCOL FOR CLIENTS – MUST READ!
- Please attend your appointment alone and only arrive to your appointment for your scheduled time slot – no earlier or later. I do have a waiting room if you are early but please bear in mind that I may be with another patient and unable to answer the door. Please do not bring children as they will not be allowed in the clinic room when you have your procedure.
- Please wear a mask – this is legal requirement
- Hand sanitiser will be provided upon your arrival
- If you have any COVID-19 symptoms please rearrange your appointment.