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Pre/Post Care

2376 South Downing Street

Denver, CO, 80210

(303) 809-4468

Your Custom Text Here

Home
Services
FAQ
Forms
Location and Hours
Pre/Post Care

Please follow the link for the service you are requesting.

Microblading

Microblading

Name *

Name

First Name

Last Name

Email Address *

Phone Number

How would you like to be contacted for an appointment? *

Text

Email

Date of Birth *

Date of Birth

MM

DD

YYYY

Are you currently pregnant/nursing? *

Yes

No

Have you ever had an allergic reaction to any of the following?

Check all that apply

Lanolin

Latex/Rubber

Vaseline

Medications

Metals

Dyes

Lidocaine

Crayons

Glycerine

Foods

List any medications you have been taking for the past 6 months:

Have you ever had any of the following:

Check all the apply:

Previous Microblading or other Permanent Makeup on the Brow Area

Trichotilomania (compulsive pulling out of the lashes or brows)

Diabetes

High Blood Pressure

Cancer

Hepatitis

Alopecia

Chemical/Laser Treatments (within past 6 weeks)

Fat Injections/Botox/Collagen Injections

Keloid Scar

Thyroid Disturbances

Epilepsy

How did you hear about me? *

Instagram

Facebook

Yelp

Referral

Other

If you chose REFERRAL or OTHER, please include who referred you or your other method below:

Additional Comments:

I understand that it is my responsibility to read through ALL paperwork (including before/after care) emailed to me BEFORE my appointment and notify my technician of any contraindications or concerns that may prevent the service from being performed. *

I understand that failure to follow after care instructions provided by my technician may lead to loss of hairstrokes and/or color. *

I understand that microblading is a 2 part process and depending on the condition of my brows, the desired look may not be achieved until the enhancement session. *

I understand that my complimentary enhancement session cannot be completed until 6 WEEKS after my initial session to ensure the brows are completely healed. *

I understand that failure to cancel at least 48 hours prior to my scheduled appointment time could lead to the loss of my deposit. *

Thank you for submitting your request to have microblading done! Please remember that not everyone is a candidate for this procedure. You will be contacted by email within 24-48 hours to schedule your appointment.

Lash Lift and Tint

Lash Lift

Name *

Name

First Name

Last Name

Email Address *

Phone Number *

How would you like to be contacted for an appointment? *

Text

Email

Date of Birth

Date of Birth

MM

DD

YYYY

Check all of the following that apply to you.

Check all that apply:

Skin Disorders

Inflammation of the Skin

Eye Disease

Eye Infections

Recent Eye Surgery

Blephartitis

Watery Eyes

Hay Fever

Allergies

Bell's Palsy

Precious Reactions to Eye Treatments

Contact Lenses

Allergy to Latex

Allergies to Adhesive, Glues, or Bonding Agents

Allergies to Acetone

Have you ever had any of the following?

Check all that apply:

Brow Tinting

Last Tinting

Lash Lift/Perm

Eyelash Extensions

Semi-Permanent Mascare

Did you experience a reaction to any of these treatments?

Check all that apply:

Yes

No

If YES, which treatment?

Please provide details of the reaction.

Did you seek medical treatment from a doctor or specialist as a result of this reaction?

Yes

No

If YES, what advice or treatment did you receive?

Thank you! If you have not booked an appointment yet, you will be contacted within 24 hours to find an appointment time that works for you!

2376 S. Downing Street Denver, CO 80210

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