Please read over the statements below carefully. We will go over this again at the beginning of your appointment. If do you not meet all of the criteria, we will not be able to move forward with the permanent cosmetic procedure. 

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I have not had an acute or delayed reaction to a previous tattoo procedure.

 

I have not been treated with Retin A, Accutane and/or chemical peels in the last 90 days

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I am not currently on blood thinners, i.e. Warfin, Coumadin, aspirin therapy or the like 

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I have not been treated with Latisse or similar eye lash growth prescriptions in the 60 days

 

I do not have any skin conditions in the area that I would like tattooed? i.e. dermatitis, moles, scars, ect.

 

I have never had cold sores, fever blisters, or shingles? (only applies if considering a lip procedure). Otherwise answer no

 

I am not allergic to numbing medications or "caine" derivatives 

 

I do not have a condition that requires me to take antibiotics prior to dental procedures 

 

I am not allergic to red dyes ex. in hair color, food additives, ect.

 

I have not had eye surgery in the last year (only applies to eyeliner procedure)

 

I am not prone to hyper-pigmentation

 

I am not prone to developing keloids

 

If you have answered "CORRECT" to all of the questions, then you are a candidate for a permanent cosmetic procedure.

If you answered "INCORRECT" to any of the questions, please consult with your physician before scheduling a permanent cosmetic procedure.

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*** Note: If I request an allergy patch test, it must be done 24 to 48 hours before procedure/s can be done.