Microneedling & Nano Infusion Consent

First Name

Last Name

Email

I give my consent and understand that Microneedling and Nano Infusion results will vary among individuals. I understand that although I may see a result after my first session, I may require a series of sessions to obtain my desired results. I understand that results are semi-permanant and not guaranteed although good results are expected.

I give my consent and understand the precautions, warnings and contraindications of Microneedling and Nano Infusion such as: Keliod scars, scleroderma, collagen vascular diseases, cadiac abnormalities, a hemorrhagic disorder or haemostatic dysfunction, active bacterial or fungal infection. Precautions should be taken by people with less than one year old scars or stetch marks, women who are pregnant or nursing, history of eczema, psoriasis, herpes simplex infections, diabetes or clientss with wound healing deficienies; including clients on immunosuppresive therapies.

I give my consent and understand that after the treatment my skin may be red or flushed. Skin may also feel tight and be mildly sensitive to touch in certain areas. This will diminish significantly with in a few hours following the treatement. Within the next 12 hours I may need to stay out of direct sunlight, or tanning beds, as the skin will be more sensitive. After 3 days the skin shoud be completely healed.

By signing this form I acknowledge that all my questions and concerns have been answered about Microneedling or Nano Infusion. This form is valid until all or part is revoked by Meredith Brooke Salon and any of its affiliates in writing.

Your Signature

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

PMU Before Care
Consent #2

First Name

Last Name

Email

I consent and understand that I may not drink ALCOHOL or CAFFEINE before the procedure (at least 24 hours for Alcohol)- Increases bleeding. Avoid exercising the day of the procedure.

I consent and understand that I may not take any blood thinners such as Advil, Asprin, Niacin, or Ibuprofen 48-72 hours before my procedure. Tylenol can be taken if you have low pain tolerance. Fish oil or vitamin E may not be taken one week prior or any other natural blood thinner.

I consent and understand that Botox shoud be done 3 weeks before or 3 weeks after the procedure. No waxing or tinting 3 days before. I must not tan within 2 weeks prior to the procedure. Do not have any type of facial/peel 1 month prior to the procedure.

Your Signature

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Lash Lift Consent

A lash lift is meant to curl your upper lashes upward and will last 6-8 weeks with proper aftercare but depends on the state of your natural lashes. Not everyone is a candidate for a lash lift. If you have thin or sparse lashes you may be advised to do a different treatment until your lashes are strong enough or you grow more lashes. In every appointment it is our top priority to lead with integrity and keep your lashes healthy.

First Name

Last Name

Email

I understand that I need to keep my lashes dry for 48 hours after I get a lift

Yes

Although most lashes curl with no problem, I understand that I cannot get a lift service back to back and must wait at least 1 week in between lifts if I don’t see desired results

Yes

I understand that if I have downward facing lashes or very straight lashes, it may take multiple sessions to get my lashes fully lifted

Yes

Are you allergic to tapes, adhesives or skin products? If yes, please explain below

I understand and agree to all statements above

Yes

I declare that the info I’ve provided is accurate & complete

Your Signature

Thanks for submitting!

Lash Extensions
Consent form

Lash extensions are a semi permanent service. With proper application and aftercare they can last up to 2-4 weeks before needing a refill. Everyone’s natural lashes are different. No set is the same. We have different lash diameters, lengths, textures, and styles. A thorough consultation will be done before you receive service, the same day of your appointment. Lash retention depends on proper after care. Our work is not guaranteed with products that are not sold in our salon. Please fill out the following form i order to receive service.

First Name

Last Name

Email

Date of Birth

I Understand that I must come in for a regular refills to keep my lashes looking full

Yes

I understand that I may not wet my lashes up to 48 hours after getting lashed. This may result in extensions falling off sooner than the 2 week period

Yes

Are you allergic to any adhesive glue tapes or skin products if yes, please list below

I declare that the info I’ve provided is accurate & complete

I understand that if I swim, sweat, cry or wet my extensions continuously they may not last as long as expected

I understand that not every lash set is the same and even though I bring in a picture it may not look exactly like the picture because natural lashes are different for every client

I understand that it is my responsibility to let the lash tech know if my eyes are uncomfortable during the service

I understand that I may not open my eyes while receiving lash extensions or answer my phone or text while receiving lash extensions to ensure my safety during the service

I understand that if I come from another salon and I have previous lash extensions applied it is to the discretion of the lash tech whether or not I will be able to receive a refill or I will need a removal and a full set. This will depends on the previous lashes are compatibility with Meredith Brooke Salon's products

I understand that if I show up to my appointment and have previous lashes on and have not notified Meredith Brooke Salon before my appointment I may have to come back a different day to receive service if the time is not allotted

Have you recently received chemotherapy treatment or do you have any conditions such as cancer or alopecia that would cause your hair to fall out? If yes, please explain below.

Are you pregnant? If yes, please keep in mind that lash extension fullset services may require laying down in a flat position for as long as two hours and refills may require laying down in a flat position for one hour. Please bring a pillow to put underneath your legs if that would be more comfortable for you if you are pregnant

Yes

No

Your Signature

Thanks for submitting!

MEREDITH BROOKE SALON

FORMS

Covid-19 Wellness Form

Microneedling & Nano Infusion Consent

PMU Brows Consent #1

PMU Before Care
Consent #2

Lash Lift Consent

Lash Extensions
Consent form

MICRONEEDLING

Please email any photos of your facial skin in the areas you want treatment .

Please also email photos of any facial products you're currently using, with the ingredient label.

Please email your photos to:
info@meredithbrookesalon.com

Policy Consent

BE THE FIRST TO KNOW ABOUT SPECIAL SALES AND NEW ARRIVALS

FORMS

Covid-19 Wellness Form

Microneedling & Nano Infusion Consent

PMU Brows Consent #1

PMU Before Care Consent #2

Lash Lift Consent

Lash Extensions Consent form

MICRONEEDLING

Please email any photos of your facial skin in the areas you want treatment . Please also email photos of any facial products you're currently using, with the ingredient label. Please email your photos to: info@meredithbrookesalon.com

Policy Consent

PMU Before Care
Consent #2

Lash Extensions
Consent form

Please email any photos of your facial skin in the areas you want treatment .

Please also email photos of any facial products you're currently using, with the ingredient label.

Please email your photos to:
info@meredithbrookesalon.com