Welcome! We’re so happy to meet you.

First Name *

Last Name

Email *

Phone *

Date of birth *

Address *

Country

Please Specify Any Allergies or Medications

SKIN CONDITIONS SECTION

Do you have any skin problems? *

Medication and Health History

Please indicate if anything listed applies to you. *

Botox / Filters

Last Date of Botox

CLIENT DISCLOSURE AND MEDICAL HISTORY

Do you have any difficulty healing wounds or scars? *

Have you ever experienced prolonged bleeding during minor injuries or surgeries? *

Have you ever had a negative reaction to tattooing or permanent makeup? *

Do you have any residual pigment or scars from previous PMU treatments? *

Do you use any products containing active ingredients like Retinol, AHAs, or BHAs? *

Do you regularly use tanning beds or expose your skin to the sun for extended periods? *

Do you have any known sensitivities or allergies to skincare products or makeup? *

TERMS OF SERVICE AGREEMENT

Please indicate your understanding and agreement by checking the boxes below. *

Client Signature *

Select Date *

Technician's Signature *

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