Allergic Reaction. There is a small possibility of an allergic reaction. You may take a 5-7 day patch test to determine this. Please initial to: Waive or Take .
Allergic Reaction. There is a small possibility of an allergic reaction. You may take a 5-7 day patch test to deter- mine this. Please initial to: Waive or Take . The alternative to these possibilities is to use cosmetics and not undergo the 3D Microblading - Brows by El Paso Microblading, semi-permanent technique. Consent and release for procedures performed: Signed: Date: Signed: Date: After care is very important for producing a beautiful and lasting result. What’s normal? I have read, understand and agree to the above instructions. Signed: Date: Emergency Person Phone: Phone#: YES NO History of MRSA YES NO Botox (Last treatment ) YES NO Diabetes YES NO Facelift YES NO Alcoholism YES NO Abnormal Heart Condition YES NO Take medication before dental work YES NO Pregnant now – Breastfeeding now YES NO Brow Lash Tinting YES NO Autoimmune disorder YES NO Oily Skin YES NO Cancer (Year ) YES NO Tumors/ Growth/ Cysts YES NO Difficulty numbing with dental work YES NO Taking blood thinners such as: Aspirin, Ibuprofen, Alcohol, Coumadin etc YES NO Allergic reaction to any medications such as Lidocaine, Tetracaine, Epinephrine, Dermacaine, Benzyl Alcohol, Carbopol, Lecithin, Propylene Glycol, Vitamin E Acetate, etc YES NO Allergies to metals, food, etc YES NO Any diseases or disorders not listed YES NO Do you use skin care products containing Retin-A, Glycolic Acid, or Alpha Hydroxyl? Please list any medications you are taking
Allergic Reaction. In this condition the eye becomes red and irritated often in response to the cleaning and/or storage solutions. It is most often seen with soft contact lenses and is usually a reaction to the preservatives in these solutions. Treatment includes changing to different solutions and storage methods as directed by your doctor.
Allergic Reaction. There is a small possibility of an allergic reaction. You may take a 5-7 days patch test to determine this. Please initial to: Waive_________ or Take _. I certify that I have read or have had read to me the contents of this form. I understand the risks and alternatives involved in this procedure(s) and I have had the opportunity to ask questions and all of my questions have been answered. I acknowledge that I have reviewed and approved the material given to me and I authorize Signature _______________________________________________ Date ____________________________ After care is very important for producing a beautiful and lasting result. • Keep the area clean by washing with freshly washed hands and a mild soap. Do not use a washcloth or sponge to remove soap. Simply splash with water. Do not use cleansing creams, acne cleansers or astringents. Use a mild, natural soap. • Apply the aftercare balm with freshly washed hands or a Q-tip. If the balm is too stiff to use simply warm it up in a glass of warm water or on your finger. Use the balm very sparingly. Too little is better than too much. Blot off excess with a clean tissue. Never touch the procedure area without washing your hands immediately before. • Do not scrub, rub or pick at the epithelial crust that forms. Allow it to flake off by itself. If it is removed before it is ready the pigment underneath it can be pulled out. • Do not use any makeup near the procedure area including mascara for eyeliner procedures for at least 3 days. Purchase new mascara and makeup if possible to avoid contamination or bacterial infection. • Always use a sun block after the procedure area is healed to protect from sun fading. • Swelling, itching, scabbing, light bruising and dry tightness. Ice packs are a nice relief for swelling and bruising. Aftercare calm is nice for scabbing and tightness. • Too dark and slightly uneven appearance. After 2-7 days the darkness will fade and once swelling dissipates unevenness usually disappears. If they are too dark or still a bit uneven after 4 weeks then we will make adjustments during the touch up appointment. • Color change or color loss. As the procedure area heals the color will lighten and sometimes seem to disappear. This can all be addressed during the touch up appointment and is why the touch up necessary. The procedure area has to be completely healed before we can address any concerns. This takes at least four weeks. • Needing a touch up months or years later. A touch up...
