Lip permanent makeup consent form

Your Name *

Email Address *

Phone *

I {name-1}, hereby consent to undergo lip blush treatment at Cosmo Esthetique by VJ. I understand and acknowledge the following:

I Agree *Procedure Description: Lip blush is a semi-permanent cosmetic tattooing procedure that enhances the natural beauty of the lips by adding color and definition.

I Agree *Treatment Risks and Side Effects: While rare, possible risks and side effects of lip blush treatment may include allergic reactions, infection, swelling, tenderness, bruising, and pigment fading or shifting.

I Agree *Expectations and Results: I understand that individual results may vary, and the final outcome of the lip blush treatment may be influenced by factors such as skin type, aftercare, and lifestyle.

I Agree *Aftercare Instructions: I agree to follow the aftercare instructions provided by the technician, which may include avoiding certain activities, using prescribed ointments, and attending follow-up appointments.

I Agree *Touch-up Sessions: I understand that multiple touch-up sessions may be required to achieve the desired results, and additional fees may apply for touch-up appointments.

I Agree *Consent for Photography: I consent to the taking of photographs before, during, and after the lip blush treatment for documentation and marketing purposes, while ensuring my anonymity.

I Agree *Payment and Cancellation Policy: I understand and agree to the payment terms and cancellation policy of Cosmo Esthetique by VJ for the lip blush treatment.

I Agree *Release of Liability: I release [Salon/Studio Name], its technicians, employees, and affiliates from any liability for any undesired outcome or complications that may arise as a result of the lip blush treatment.

I Agree *Confirmation of Understanding: I confirm that I have read and understood the information provided in this consent form, and I have had the opportunity to ask questions and clarify any concerns before proceeding with the treatment.

I Agree *I acknowledge that I am undergoing the lip blush treatment of my own free will and that I have been given ample time to consider the risks and benefits associated with the procedure.

I Agree to Refund Policy *Refund Policy: All services rendered by Brows by VJ are provided on a non-refundable basis. Customer agrees not to charge back any credit card payments for services rendered. In the event that a customer files a charge back or other payment dispute, they will be considered to be in violation of this agreement and may be subject to collection action

To secure your appointment with us, a non-refundable deposit of $50 is required at the time of booking. If you need to reschedule, please notify us at least 48 hours in advance. If we do not receive notice within that time frame, the deposit will be forfeited.

If you need to book another appointment, a new $50 deposit will be required to reserve your spot. We appreciate your understanding and cooperation!

Date: 03/15/2025

Lip permanent makeup consent form

Professional & Certified Staff

Contact

Business hours

Forms

Quick Links

Locations

Thanks for Booking

Please call (470) 802-7697 to
confirm your Booking

Lip permanent makeup consent form

Professional & Certified Staff

Contact

Business hours

Forms

Quick Links

Locations

Thanks for Booking

Please call (470) 802-7697 to confirm your Booking

Please call (470) 802-7697 to
confirm your Booking