Pre Session Safety Consent

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Consent

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Medical History


In order to provide you with the most appropriate treatment, please complete the following questionnaire. All of the information is strictly confidential and not shared with any third parties.

Are you currently under the care of a physician?*
Do you have any of the following medical conditions/problems?*
(please check the boxes that applies to you)
Have you ever had an allergic reaction to any of the following?*
(please check the boxes that applies to you)
Please list:
Please list:
Please list:
Have you recently had treatments such as peels, microdermabrasion, etc. on your face?*
Do you form thick or raised-scars from cuts or burns?*
Do you get Hyper-pigmentation (darkening of the skin), Hypo-pigmentation (lightening of the skin) or marks after physical trauma?*
Which of the following best describes your skin type?*
Have you had any recent tanning or sun exposure that changed the color of your facial skin?*
Gender*
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Consent - Medical*

Permanent Makeup Cancellation & No-Show Policies

service will be allowed Permanent makeup is all about you! We want to provide you with the highest standards of service and personal care, in the most professional environment so that you will return and recommend our services.

Appointments: 

To schedule any Permanent Cosmetic Appointment, we require a $100 None-Refundable Deposit Fee for securing your spot for appointment. This deposit needs to be paid at the time of booking.

Initial Consultation: $50 None-Refundable Consultation Fee is required at the time of booking.  The $50 will be credited to your procedure cost.  If you cancel/reschedule your appointment less than 48 hours’ notice you will lose the $50 and require a new deposit to be paid before rescheduling your next appointment.

Cancellation – If you have an appointment, this time is reserved exclusively for you. If you must cancel your appointment, we require a 48-hour cancellation notice in advance for services.

Rescheduling:

If you need to reschedule an existing appointment, please give us 48 hours’ notice and we will carry your deposit over to the new appointment this can. Only be moved ONE time only please, any rescheduling after you will lose your deposit. We encourage you to contact us directly by phone or by text when needing to cancel or reschedule your appointment.

Emergency:

If you have a medical emergency and must cancel with less than 48 hours' notice, please provide your medical receipt and your appointment can be rescheduled for another time with no additional deposit required.

No Show Policy:

Any client that DOES NOT SHOW for a scheduled appointment will forfeit their $100 deposit and will be required to pay for any future appointment in full.

Late Arrival:

Arriving more than 30 minutes after, you will have to be rescheduled and we will move your deposit ONE time only. This is as a curtesy to the following guest since we can’t extend their time.

Please be mindful when you do not cancel or reschedule your appointment in a timely manner, it affects three parties: you, the technician, and other clients. Thank you for your cooperation. We look forward to your visit.

No Other Guests:

Due to liability reasons no other guests or children are allowed in the salon’s treatment area. We want to provide the best relaxation atmosphere for clients only. Thank you for your understanding.

Cell Phones:

Cell phone use is not permitted while permanent makeup services are rendered.

Permanent Makeup Done by Another Technician:

Recoloring permanent makeup done previously by anyone else is not “just a touch-up” since it is not the original work of our provider. Therefore, fees start at the new permanent makeup prices. Two or more appointments may be necessary to achieve and complete most permanent makeup correction procedures.  Note: Permanent Makeup Maintenance / TOUCH-UP – Touch-up’s are not included in the original procedure fee.

Pricing: All prices quoted are subject to change without notice. All purchases and services are final, and there are NO refunds.

Credit card payments incur a 3% fee. Remaining balance is due on the day of your procedure. Accepted methods: cash, check, Zelle, Venmo.

Venmo Contact: (773) 396-0620

Zelle Contact: (239) 744-9866

Additional Treatment Policy
  1. We reserve the right to refuse services to anyone.
  2. Two or more appointments may be necessary to achieve and complete most permanent makeup procedures depending on each person’s skin. Touch-up fees will apply.
  3. Since scar tissue is abnormal, multiple sessions are usually needed to achieve satisfactory results with medical grade camouflage.
  4. Only clients receiving within the treatment room.

Consent - Permanent Makeup Cancellation & No-Show Policies*

Request and Consent to Photography and/or Video Record

Request and Consent to Photography and/or Video Record
Your aesthetician may need to photograph and/or record you to document a medical condition, help with diagnosis and/or treatment of a condition, and/or to help plan the details of a treatment. Photographs and/or recordings taken for these clinical reasons do not require your written permission. Your aesthetician does need your written permission to use your photographs and/or recordings for the non-clinical reasons below. I hereby authorize Microblading by Joanna, including the attending aesthetician or other designated person(s), to photograph and/or video me for the following purposes: 1. To show or release to current or future Microblading by Joanna patients on company website for the purpose of education and consultation. I understand these photos or videos can be taken at any time during my treatment which includes pre-treatment, post-treatment, pre-operative, intra-operative, post-operative photos, and/or videos of my treatment.
Consent - Photography and/or Video Record*
I hereby certify that all of the information provided by me in this application is correct, accurate and complete to the best of my knowledge.
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Consent Form – Previously Tattooed Eyebrows

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Procedure

Important Information About Previously Tattooed Eyebrows

I understand that my eyebrows have been previously tattooed or treated with permanent makeup, and that this has an impact on how my skin heals and retains pigment.

I acknowledge and understand the following:

  • Previously tattooed skin may contain scar tissue, fibrosis, or altered skin structure, which can affect pigment implantation and retention.
  • Due to prior tattooing, my skin may be thinner, less elastic, or uneven, which can result in lighter results during healing.
  • During the healing process, the eyebrows may appear to fade significantly or temporarily disappear. This is a normal part of healing and does not indicate a failed procedure.
  • New skin can form over the pigment, creating a cloudy or milky appearance that hides the color until the skin fully regenerates.
  • Pigment oxidation and color return may take longer than on virgin (untattooed) skin, often up to 2–4 weeks or longer.
  • Previously tattooed skin may exfoliate faster, which can cause pigment to resurface unevenly or appear lighter during healing.

Healing & Results Disclaimer

I understand and accept that:
  • Final results cannot be guaranteed on previously tattooed eyebrows.
  • Multiple sessions, including mandatory touch-up appointments, may be required to achieve optimal results.
  • Color retention, symmetry, and longevity may vary due to existing tattoo work.
  • Additional corrective sessions may be recommended and may involve additional cost.

Client Acknowledgment & Consent

I confirm that:
  • I have fully disclosed my eyebrow tattoo history to my artist.
  • I have read and understood the information above.
  • I have had the opportunity to ask questions and all questions were answered to my satisfaction.
  • I consent to proceed with the procedure, understanding the risks, limitations, and healing expectations related to previously tattooed eyebrows.
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Eyebrow Healing Process Explanation

Why Eyebrows Can “Disappear” During the Healing Process

Eyebrows may appear very light or seem to disappear during the healing process after microblading or permanent makeup. This reaction is completely normal and can be more noticeable on eyebrows that were previously tattooed.

1. Scabbing and Natural Pigment Loss

During healing, small scabs form on the skin surface. When these scabs fall off, they often remove excess surface pigment, which can cause the eyebrows to look significantly lighter or temporarily faded.

2. New Skin Formation Over the Pigment

As healing progresses, new skin forms over the implanted pigment. This fresh skin layer can appear slightly cloudy or milky, making the pigment underneath less visible until the skin fully regenerates.

3. Previously Tattooed Brows and Skin Tissue Damage

Eyebrows that have been tattooed in the past often have altered skin tissue due to prior procedures. This may include scar tissue, fibrosis, thinner skin, or reduced elasticity. These changes affect how the skin absorbs and retains pigment. As a result, pigment may heal unevenly, appear lighter during the healing phase, or take longer to resurface. This does not indicate a failed procedure—it simply means the skin requires additional time and, in many cases, multiple sessions to achieve optimal results.

4. Delayed Oxidation of Pigment

In previously tattooed or compromised skin, oxygen reaches the pigment differently. This can slow the oxidation process, causing the color to return more gradually over a period of two to four weeks.

5. Faster Exfoliation in Compromised Skin

Skin that has undergone previous tattooing may exfoliate more rapidly, pushing pigment upward before it settles fully. This can create a temporary “ghost brow” effect during healing.

Typical Healing Timeline

Days 1–7: Brows appear dark and bold

Days 7–14: Brows may look very light or almost invisible

Days 14–30: Color gradually returns

Weeks 6–8: Touch-up session is performed to perfect color and shape

Client Reassurance Statement

“Because your eyebrows were tattooed previously, the skin needs extra time to heal and accept pigment. Temporary fading is expected, and the color will continue to return. This is why touch-up sessions are an essential part of the process.”

Micropigmentation Healing & Skin Disclosure Consent

I understand that micropigmentation is a cosmetic procedure and that the healing process varies from client to client. I acknowledge that eyebrows may temporarily appear very light or seem to disappear during the healing phase, which is a normal and expected part of the process.

I understand that during healing, scabbing and natural exfoliation may remove excess surface pigment. Newly regenerated skin may temporarily conceal the pigment, making the brows appear faded until the skin fully heals and oxidation occurs.

I acknowledge that if my eyebrows were previously tattooed or treated with permanent makeup, the skin tissue may be altered. This can include scar tissue, fibrosis, thinner skin, or reduced elasticity, which may affect pigment retention, color visibility, and healing time. Previously treated skin may require additional time, multiple sessions, and touch-up procedures to achieve optimal results.

I understand that final color results cannot be evaluated until the complete healing process is finished, which may take up to 6–8 weeks. I acknowledge that touch-up sessions are an essential part of the micropigmentation process and are necessary to perfect color and shape.

I confirm that I have had the opportunity to ask questions, that all my questions have been answered to my satisfaction, and that I fully understand the healing process, risks, and limitations associated with micropigmentation.

Client Information:

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Client Acknowledgment & Signature

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Healing Process & Pigment Retention Consent

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I understand that permanent makeup and microblading require a healing process and that the appearance of my eyebrows will change during this time.

I acknowledge that during the healing process, scabbing and skin regeneration may cause the pigment to appear significantly lighter or temporarily disappear. I understand that new skin forming over the pigment may create a cloudy or faded appearance before the color gradually returns. Final results cannot be evaluated until the skin has fully healed, which may take up to 30 days.

I understand that previously tattooed or microbladed eyebrows may have altered skin tissue, including scar tissue, fibrosis, or reduced skin elasticity. These conditions can affect how the skin absorbs and retains pigment, resulting in uneven healing, lighter color during the healing phase, longer healing time, and the need for additional sessions to achieve the desired results.

I acknowledge that these healing characteristics do not indicate a failed procedure and that touch-up sessions are a normal and essential part of the permanent makeup process.

I understand that results may vary depending on individual skin type, previous tattoo work, lifestyle, and adherence to aftercare instructions. I acknowledge that no guarantees can be made regarding pigment retention, color longevity, or outcome.

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