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Today's Date:
Sat May 4 2024 05:07
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This is the procedure form for the cosmetic tattooing procedures done by Jeni Hart of Brows & Beyond. This form shows the equipment used, documents photography, stores procedure notes, eyeliner release signing.
Please read and answer
Y
N
The Fade™
This is the first session of the soft ombré brow look using a machine to implant pigment into the dermal/epidermal layer using pigments agreed upon by you after the design has also been approved by you.
Y
N
The Flow™
Hairstrokes are made to mimic hair in your eyebrow area. These are similar to microblading however they are made with a digital machine, not a manual tool as in microblading.
Y
N
The Flick™ Mini
Pigment is placed into the lash line on the UPPER lash line only. This procedure makes the lash line appear thicker at the roots. This is NOT an eyeliner procedure. The pigment will fade to a charcoal and may require a follow up visit to perfect if some pigment has been lost through the process of healing.
Y
N
Lower Lash Enhancement
Pigment is placed into the lash line on the LOWER lash line only. This procedure makes the lash line appear thicker at the roots. This is NOT an eyeliner procedure. The pigment will fade to a charcoal and may require a follow up visit to perfect if some pigment has been lost through the process of healing.
Y
N
The Flick™ Full
Pigment is placed into the lash line on the UPPER & LOWER lash line. This procedure makes the lash line appear thicker at the roots. The pigment will fade to a charcoal and may require a follow up visit to perfect if some pigment has been lost through the process of healing.
Y
N
The Fill™
A lip tattoo to define the edges and add colour to the body of the lips.\r\nYou must ensure you have taken oral Acyclovir tablets 3 days prior (on prescription from your GP) regardless of how long ago you have had a breakout. This is very important!
 
Consultation Date*
 
 
Procedure Date*
 
 
Pigment Description*
 
 
Sterilised Needles Opened *
Client to sign to acknowledge please
 
 
Anesthetic Used*
 
Y
N
Before Photo Taken?*
Y
N
After Photo Taken?
 
Eyeliner Procedure Only*
If eyeliner was conducted, the client attests to being released in good condition: Client must sign form.
 
 
Procedure Notes by Technician*
Notes:
 
You have had a thorough explanation of the circumstances that may lead to different outcomes for your tattoo. You have been given aftercare instructions and had Jeni run through these with you. You understand that in some cases a 3rd touch up may be needed with certain skin types and nothing can be guaranteed. You also understand that every skin type is different and not all techniques are suited to your skin type.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Name:*
Address:
Postcode:
Date of birth:*
You must be 18 or older
Phone #:*
Email:*
Signature:*


Photo ID*
Please take photo(s) of your government issued photo IDs and related paperwork.