Permanent Makeup (PMU) Consent Form

Personal Information

Procedure Type

MicrobladingNanobladingOmbre BrowsLip BlushEyeliner EnhancementBikini TintingBreast Nipple TintingScalp PigmentationCombination BrowsBB GlowBotox TreatmentIV DripFillers TreatmentThread TherapyVideo Consultation

Treatment Area

PMU Artist Name

Health Declaration

I have NOT used Accutane/Isotretinoin within the last 6 months.

I am NOT under the influence of alcohol or recreational drugs.

I do NOT have an active skin infection, rash, or open wound.

I am NOT undergoing chemotherapy or major medical treatment without physician approval.

Photo Consent

I authorize Arch & Pout to use photographs and videos for marketing, website and social media purposes.

Consent Agreement

I have read and understood all risks and voluntarily consent to the procedure.

Digital Signature

Please type your full legal name below.