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Skincare Consultation

Forms

Skincare Consultation

Informed Consent

 Release of Liability: 

I acknowledge that the information that I have provided is true to the best of my knowledge. I have been fully informed of the potential risks associated with a body art procedure. I still wish to proceed with the body art application and I assume any and all risks that may arise from body art &/or Follicure

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Health History

Do you have any active skin conditions (e.g., eczema, psoriasis, dermatitis)?
Yes
No
Have you had any recent surgeries or injuries in the area to be treated?
Yes
No
Are you prone to keloid scarring?
Yes
No
Are you currently pregnant or breastfeeding?
Yes
No
Do you have any blood disorders (e.g., hemophilia) or are you on blood-thinning medications?
Yes
No
Are you immunocompromised (e.g., HIV/AIDS, undergoing chemotherapy)?
Yes
No
Do you have any allergies to tattoo pigments, latex, metals, alcohols, serums or other materials that may be used in the procedure?
Yes
No
Do you currently have any active infections (bacterial, viral, fungal) in the area to be treated?
Yes
No
Have you recently tanned or had a sunburn in the area to be treated?
Yes
No
Do you have any autoimmune skin disorders (e.g., lupus, vitiligo)?
Yes
No
Are you diabetic?
Yes
No
And if yes is your condition well controlled
Yes
No
Have you used Accutane or other strong retinoids in the last 6 months?
Yes
No
Are you are sensitive or allergic to any essential oils, ie. Coconut, Avocado, Argan etc.?
Yes
No

The Client understands that the following conditions may contraindicate the procedure:


• Active skin conditions

• Recent surgeries or unhealed scars

• Prone to keloid formation

• Pregnancy or breastfeeding

• Blood disorders or use of blood-thinners

• Immunocompromised status

 • Allergies to pigments or materials used

 • Active infections • Recent tanning or sunburn

 • Autoimmune skin disorders 

• Diabetes (if not well-controlled)

 • Recent use of Accutane or strong retinoids


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Year
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Wavier and Release of responsibility - Hidden Hue Paramedical

1. Release of Liability

I acknowledge that the information that I have provided is true to the best of my knowledge. I have been fully informed of the potential risks associated with a body art procedure. I still wish to proceed with the body art application and I assume any and all risks that may arise from body art &/or Follicure


2. No Refund Policy

The Client understands and agrees that all payments made for the procedure are non-refundable. The Client acknowledges that the Artist cannot guarantee specific results, as individual outcomes may vary.


3. 📸 Photography & Image Use Consent Clause

I understand that photographs may be taken before, during, or after treatment for the purpose of documenting progress and maintaining accurate clinical records. These photos are a standard part of client charting and will be stored securely. I acknowledge that I have the option to consent or decline the use of these photos for educational, marketing, or printed materials).

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