Semi-Permanent Make-Up Consent
Medical Questionnaire

Terms of your treatment

  • I understand that Semi Permanent Make Up is a process with healing variables, therefore healed colour cannot be guaranteed.

  • I understand that SPMU is a multi treatment process with colour being implanted slowly and carefully over a period of time in a layering process.

  • My chosen colour will look much darker when initially implanted but should be exfoliate and lightened within 7/14 days. I understand that additional work cannot be undertaken for 4-8 weeks, in order to allow the skin to heal fully.

  • I understand that all colours will fade and alter with time. To keep a fresh appearance, a re-touch procedure will be required every 12-18 months, Fade is dependent on age, skin type, medication and colour chosen and skin exposure.

  • I agree that my specialist will use a Treatment Plan to keep a log of the colours chosen, along with my pre and post treatment photographs. This information will be held securely in a confidential file.

  • I understand that after each treatment the area may swell or show redness and, in some cases, bruising. My specialist will recommend how to take care of this. I may experience some discomfort but my specialist will reassure me throughout and will endeavour to make me feel comfortable.

  • I understand that if I have a MRI or CAT scan I must tell my radiologist that I have had an SMPU procedure. I may experience slight tingling in the affected area.

  • I have been given aftercare instructions and I understand that I must adhere strictly to these instructions.

  • I am aware that any sun exposure, future skin altering procedures, such as plastic surgeries, peels, implants, and/or injectables may alter the appearance of my procedure.

  • My technician has discussed likely outcomes with me and recommended a treatment plan, prior to any work being agreed and undertaken.

  • I understand that permanent cosmetics/medical enhancement is an advance form of tattooing.

  • I accept responsibility for determining the colour, shape and position of the enhancement as agreed during the course of my consultation.

  • I am aware that a sensitivity reaction to anesthetics can occur and accept all responsibility if allergic response occurs.

  • I fully understand and accept that non-toxic pigment is used during the procedure and that cosmetic enhancement achieved may fade over 1-3 years. Even though the colour has faded, the pigment will stay in the skin indefinitely a may leave a light residue of colour.

  • I understand that loss of any eyelashes during the healing of permanent cosmetic eye enhancements will result in new eyelash growth over a 4-month period and that eyelash loss is rare and minimal.

  • I understand that the pigment may migrate under the skin, however this is a rare occurrence.

  • I understand that immediately after the procedure the enhancement can be 30% to 50% darker than the desired result and can take up to 10 days to lighten.

  • I understand that the true colour will be visible 4 weeks after each application, and that the colour may vary according to skin tones, skin type, age and skin conditions. I appreciate that some skins accept colour more readily than others and no guarantee of an exact effect or colour can be given.

  • I understand that the lip procedures may stimulate may dormant viruses such as herpes (cold sores) I have been made aware that anti-herpes medication is available over the counter or on prescription and has been shown to prevent or minimise outbreaks,

  • I am aware that is I have had a previous eye disorder or eye infection and receive eyelash enhancement, the disorder may reoccur again.

  • I agree to use the correct medication to prevent such a disorder re-occurring.

  • I understand that I may experience dry lips for up to 2 weeks following permanent cosmetic lip enhancement.

  • I agree to follow all pre-procedure and post-procedure instructions as provided and explained to me by my practitioner.

  • I understand that infection and possible scarring can occur if I do not adhere to the said instructions.

  • I understand that If I do not allow the technician to complete the procedure I accept responsibilities for the result.

TITANIUM DIOXIDE – is a clear ingredient in our pigments and is not always visible in the skin, even though it may be present. Some cosmetic lasers will permanently alter the colour of the titanium dioxide, therefore is it vital that you inform your laser specialist where your micropigmentation is. Your laser specialist ill take steps to ensure any adverse reactions.

 

NICKEL - I understand there are traces of nickel in some needles and pigments. This may affect me if I have an allergy to nickel. (in case a patch test is strongly recommended)

  • I understand my condition or medication may affect the treatment including bruising, bleeding and additional healing 

  • I understand the importance of providing an accurate and complete medical history and that withholding any medical conditions may be detrimental to my health and the outcome of the procedure

  • I understand that there are no guarantees as to the success or longevity of my treatment. My technician has explained the treatment and I fully understand the process

  • I have been given aftercare instructions and I understand that I must adhere strictly to these instructions

  • I accept these terms and hereby give my written consent for a trained specialist to carry out the course of treatment of my choice

My medical practitioner may use pictures/videos taken before and after my treatment for the social media or within clinic. Please tick appropriate box.​​

I certify that I have read and fully understand the above consent form and that I have requested to have permanent cosmetic enhancement of my own free will.