Name * First Name Last Name Phone * (###) ### #### Email * Permanent Makeup Treatment * I understand that permanent makeup involves inserting pigment into the skin using sterile needles and that a preliminary brow shape will be mapped before the procedure begins. I acknowledge that results will vary based on age, skin type, lifestyle, and aftercare, and that touch-up sessions are often required and may have an additional cost. I understand that the pigment will appear darker in the first few days, and minor irritation, redness, or inflammation may occur and typically resolves within 24–36 hours. I consent to the use of topical numbing agents during the procedure and understand that individual responses may vary. Possible side effects may include light-headedness, allergic reaction, dizziness, or nausea. Yes Contraindications & Pre Treatment Screening * I am not diabetic I have not tested positive for the HIV or Hepatitis Viruses I am not hemophiliac I am not allergic to Red Lake #5 I have not had Botox or Filler injectables in the last 3 weeks I am not pregnant I am not currently breastfeeding I have informed the technician of any medication I am currently taking, which may affect blood coagulation during the procedure * I hereby declare that I am not intoxicated The above is all true Please list any medications/allergies * Post Treatment * I understand that during the first 7 days after treatment, I should not: expose the treated area to UV rays, tanning beds, use a sauna or swimming pool, use makeup around my brows and will not pick off flaking or scabbing area. I understand that following Aftercare instructions is essential in my healing & ensuring the best results of the treatment Yes Touch Up Policy * If a touch-up is included in a promotional package, it is up to me, the client, to book it within 6 to 11 weeks of my initial appointment. I understand that if I book outside this timeframe, additional charges may apply. I understand & agree Disclaimer * I give consent to have PMU Brows performed and assume full responsibility for the outcome. I understand that results may vary and I will not hold the technician, Attajaan Ramji, liable should the result differ from what was discussed or imagined. I understand that the price agreed upon is final. No additional discounts or promotional offers will be applied after booking. I acknowledge that there are NO refunds on this service under any circumstances. This agreement will remain in effect for this procedure and all future procedures conducted by my technician. I understand that this consent is legal and binding. Yes Rescheduling Policy * At Unfiltered Beauty, appointment times are thoughtfully reserved just for you. To reschedule your appointment, I require a minimum of 7 days’ notice. This allows me to offer your spot to another client and maintain a smooth booking experience for everyone. If you request to reschedule with less than 7 days’ notice, a rebooking fee will apply. If you request to reschedule with less than 48 hours' notice, you will be charged 50% of your original service. To secure a new time slot, you’ll be asked to pay the rebooking fee or full amount upfront, depending on the timing of the change. These policies apply regardless of the reason for rescheduling, including work conflicts, illness, transportation issues, or weather, as each appointment is carefully scheduled in advance. Thank you for valuing the time and care that goes into preparing for your service. Yes Late Arrival Policy * At Unfiltered Beauty, each appointment is carefully reserved to ensure you receive the full attention and service you deserve If you arrive a few minutes late, a one-time grace period will be offered. If you are 10 minutes late to any future appointments, a $25 late fee will apply. If you arrive 15–20 minutes late and I am still able to accommodate you: • Your service time will be shortened to stay on schedule • A $75 extended time fee will automatically apply for appointments longer than 1 hour If you arrive more than 20 minutes late, your appointment will be cancelled and you will be charged 50% of the full service cost. To rebook, you must pay the full cost of a new appointment. These charges apply regardless of the reason — including traffic, parking, or difficulty finding the studio — as appointment slots are booked exclusively for each client. Thank you for understanding and respecting my time and the commitment I make to every client! I understand & agree Media Consent * I give permission for my technician to take photographs and video recordings, before, during, and/or after my procedure. I give permission for my photos to be used on the company social media channels, website and used for any other marketing purpose. I further understand that there will be NO financial remuneration for this. I agree to photos/videos ONLY for my personal profile I agree to photos/videos being used for both my personal profile AND for marketing purposes Digital Signature * By entering my name below, I confirm this serves as my legal digital signature and consent to the terms outlined above. Todays Date * Thank you for submitting your consent form!I will be in touch soon to schedule your patch test. Permanent makeup consent