BROW LAMINATION CONSENT fORM

BROW LAMINATION CONSENT FORM

PATIENT INFORMATION:

First Name

Last Name

Date Of Birth

Phone/Mobile

City

Next Of Kin

Kins Contact Number (Phone/Mobile)

MEDICAL HISTORY

Have you had any recent eye surgery or medical procedures involving the eye area?

Yes

If Yes, please specify:

Do you currently have any eye conditions or infections (e.g., redness, irritation, conjunctivitis, swelling)?

Yes

If Yes, please specify:

Do you have any known allergies or sensitivities to adhesives or cosmetic chemicals?

Yes

If Yes, please specify:

Have you completed a patch test for lamination products at least 24–48 hours prior to this treatment?

Yes

Are you currently wearing contact lenses, and are you willing to remove them before the procedure?

Yes

If No, please specify why:

Do you have any relevant other medical condition?

Yes

If Yes, please specify:

Procedure Description:

I understand that I am receiving a brow lamination treatment. Brow lamination is a non-invasive cosmetic procedure that involves restructuring the brow hairs using specialized chemical solutions to create a fuller, lifted, and more defined appearance.

I understand that:

A patch test is strongly recommended prior to treatment to reduce the risk of allergic reactions or skin sensitivity.
I must arrive without any makeup, oils, or skincare products on the brow area.
I should avoid using retinol, exfoliating acids, or harsh skincare products around the brow area at least 48 hours before the appointment.
I should inform my technician of any skin conditions, sensitivities, recent treatments, or allergies that may affect the procedure.

During the treatment, I will be required to remain still while the solutions are carefully applied and processed on the brow hairs and surrounding skin.

I understand that the procedure involves the use of chemical solutions that temporarily alter the structure of the brow hairs.

I understand that results vary depending on my natural brow hair texture, skin type, and adherence to aftercare instructions. Proper aftercare is essential to maintain the results and health of my brows.

Benefits and Risks:

I have been informed that the potential benefits of this treatment may include:

Fuller, more defined, and lifted-looking brows
Improved brow shape and symmetry
Easier daily brow styling and reduced need for makeup products
Long-lasting results with proper care

I understand that there are potential risks and side effects associated with this treatment, including:

Mild itching, dryness, or flaking in the treated area
Allergic reactions to the solutions used during the procedure
Uneven results if proper aftercare is not maintained

I understand that serious complications are uncommon but may occur in rare cases.

Aftercare:

I agree to follow the post-treatment instructions provided by the clinician to ensure the best possible results and minimize any risks. I understand that failure to adhere to these instructions may increase the likelihood of complications.

Consent for Treatment:

I hereby consent to receive brow lamination. I acknowledge that the clinician has explained the procedure, its benefits, and potential risks to me. I have had the opportunity to ask questions, and all of my concerns have been addressed to my satisfaction. I understand that the results of the brow lamination can vary.

Release of Liability:

I release The Abram, its employees, and representatives from any liability associated with the brow lamination procedure, except for cases of negligence or intentional misconduct.

Human Error Acknowledgment:

I understand that aesthetic treatments are performed by qualified clinicians using professional equipment and established protocols. However, I acknowledge that, as with any procedure involving human involvement, there is a possibility of unintended outcomes due to human or technical error. By signing this consent, I accept this inherent possibility and agree that The Abram and its staff shall not be held liable for minor or unintentional errors occurring during the course of treatment, provided that reasonable care and professional standards are followed.

Photographs and records:

I understand that videos and photos will be taken for medical documentation purposes and will be used only for treatment comparisons and tracking progress milestones.

Client's Initial

Receptionist's Initial

Technician's Initial

I agree that all the above information is true and accurate to the best of my knowledge

Client’s signature: