Microblading/Permanent Cosmetics Form

 Microblading + Permanent Cosmetics Consent Form

POP lash & Beauty Bar performs microblading procedure in strict compliance with all hygiene and health protection measures regulated by the state of California. 

In order to perform the Microblading procedure safely, please read the microblading information tab and answer the following health questions honestly. 

All information given is confidential. Pop Lash & Beauty Bar assumes no liability in the case of false information given by the client. I, POP Lash & Beauty Bar, have a no refund policy and I reserve the right to refuse service to anyone.
Name *
Have you had or have any of the following conditions? *
Check all that apply
Are you taking blood-thinning medication? *
Are you pregnant? *
Are you taking any medications on daily basis? *
Do you have a pacemaker? *
Do you have problems with wound healing? *
Have you consumed drugs or alcohol in the last 24 hours? *
Do you use Retinol? *
Are you taking Accutane? *
I agree to before and after photos and allow POP Lash & Beauty Bar to use the photos for advertising purposes. *
Agree to Terms *