Procedure Compliance Online Form

NO FACIAL MAKEUP is to be worn on procedure days, regardless of which facial area you are having tattooed. This is a cross-contamination issue. We are saving you from the possibility of an infection. In addition, long lasting eyeliner, long lasting mascara and long-lasting foundation must be avoided for 2 DAYS BEFORE your procedure. Long last lip colors or stains must be avoided for 5 DAYS BEFORE lip procedures.

NO NSAIDS or contraindicating medications or supplements for 7 DAYS BEFORE and 7 DAYS AFTER procedures. This list includes but is not limited to: Ibuprofen (Advil, Motrin), Naxproxen (Aleve), Aspirin or baby Aspirin (Bayer, Excedrin, Bufferin), Migraine medications, Vitamin E, Fish Oil, Flax Seed Oil, Turmeric, and St. John's Wort. Certain diets may be problematic as well, especially ones high in Omega 3's.

Prescribed medications are NOT to be discontinued without the prescribing physician's written clearance. Ivey Artistry is not responsible for individuals who electively choose to stop taking prescribed health medication(s). If you will be taking prescription medication(s) that may alter your ability to see or drive, please arrange for alternate transportation in advance. Recreational drug use must be disclosed to the technician.

Oral antibiotics may or may not influence the healing and/or the color of the tattoo. It is best to follow the instructions of the prescribed medicine and schedule your procedure when your physician feels it is safe to continue. Ideally antibiotics should be out of your system for 2 WEEKS before a procedure.

NO COFFEE OR OTHER CAFFEINATED BEVERAGES on the DAY of your procedure. Caffeine intake blocks anesthetic and prolongs bleeding. You may resume your intake after your procedure.

NO ALCOHOL consumption for 48 HOURS BEFORE and 7 DAYS AFTER.

NO EXERCISE THE DAY OF & for 7 DAYS AFTER all procedures, NO EXCEPTIONS. Chlorinated pools, hot tubs, gyms and saunas are unclean environments for a healing tattoo. Bacterial infections and poor healing may occur.

NO SUN EXPOSURE, SUNLESS TANNING OR SELF TANNER for 2 WEEKS AFTER your procedure. Tanning beds are considered an unclean environment for a healing tattoo.

Cosmetic injections, plastic or reconstructive surgery, laser treatments, cosmetic enhancements, topical medications, beauty services such as facial peels or microdermabrasion all need to be disclosed. There are specific time frames with each of these treatments that must be considered if you are having permanent cosmetics done. For your safety, we will not be able to perform your procedure unless we have full disclosure of any facial enhancements, even if it is not directly related to the area in which you are having work done.

must be avoided for 12 MONTHS PRIOR to any facial procedure. All other medications/supplements must be investigated by the client.

Latisse must be avoided for 6 WEEKS BEFORE and resuming is not suggested on the treated area(s). Rapid Lash may be used 4 WEEKS AFTER your eyeliner procedure.

Facial waxing should be performed no later than 2 DAYS BEFORE the procedure application and no sooner than 7 DAYS AFTER.

EYELASH EXTENSIONS MUST BE PROFESSIONALLY REMOVED by your lash technician at least 24 HOURS BEFORE any eyeliner procedure. Ivey Artistry will not remove eyelash extensions and will decline your service without refund if you fail to comply.

If you wear contacts, you will need to bring a pair of glasses as most clients are unable to insert contacts after the procedure.

I have been informed of the nature, risks and possible complications and consequences of permanent pigmentation. I understand the permanent skin pigmentation procedure carries with it known and unknown complications and consequences associated with this type of cosmetic procedure, including but not limited to: infection, scarring, inconsistent color, spreading, fanning or fading of pigments. Corneal abrasions are a rare side effect, especially if I rub or scratch my eyes or apply contacts too soon after any eyeliner procedure. I understand the actual color of the pigment may be modified slightly, due to the tone and color of my skin. I understand there may be a certain amount of discomfort or pain associated with the procedure and that other adverse side effects may include minor and temporary bleeding, bruising, redness or other discoloration and swelling. Fading or loss of pigment may occur. Although the skin of the tattoo procedure site is cleaned with an anti-microbial cleanser, it is not likely all bacteria will be killed. Deeper layers of skin inhabit micro-flora bacteria. Infection can result from resident micro-flora bacteria not removed even with the use of a thorough skin cleansing. Infections can be acquired anytime the skin is broken. The tattoo process in general leaves the skin barrier open for days and the recipient vulnerable to infection.

I acknowledge that hyper-pigmentation (darkening of the skin) or hypo-pigmentation, (absence of color in the skin), or scarring is a possibility as result of my body's reaction to the skin being broken during the procedure. I realize that my body is unique and Ivey Artistry cannot predict how my skin may react as a result of this procedure.

I acknowledge the receipt of written instructions advising me of the proper care of my procedures and I recognize the absolute necessity for following these instructions. I understand that my failure to do so may jeopardize my chances for an optimal outcome.

I understand that if I have any skin care treatments, laser hair removal, plastic surgery, or other skin altering procedures, it may result in adverse changes to my permanent cosmetics. I acknowledge some of the potential adverse changes may not be correctable. If permanent cosmetics present possible complications to my existing cosmetic enhancements, treatments, or surgeries I will consult with a physician and obtain medical clearance. If I choose to move forward with permanent cosmetics without obtaining medical clearance I assume the responsibility and consequences. I understand that future laser treatments or other skin altering procedures, such as plastic surgery, implants and injections may alter and degrade my Permanent Makeup. I further understand that such changes are not the responsibility of Ivey Artistry. I further understand that such changes in my appearance may not be correctable through further permanent makeup procedures.

If I am on any medication for depression or any other mood-altering prescription I will advise my technician. If I have ever had cold sores, I will consult with and strictly follow my doctors' instructions before contemplating any permanent cosmetic procedure around my lips. I understand that this is a cosmetic procedure and not to treat a health condition. It is my responsibility to obtain advice by a medical professional for my best interest if I have any medical related concerns. I release Ivey Artistry and its technicians and affiliates of all liability for this self-elected procedure.

I understand that tattoos may cause MRI (Magnetic Resonance Imaging) artifacts and that there may be a warming and/or tingling sensation in the permanent cosmetic procedural area during the MRI due to the iron oxide properties of some pigments. It is understood that I will notify my Radiologist, Physician, and/or Technician of having permanent cosmetics. Ice packs can regulate the temperature of the skin during an MRI procedure.

For documentation for the file and comparison, the taking of before, during and/or after photographs of my procedure(s) are required for record purposes and for use in presentation portfolios and is a condition of said procedures.

I acknowledge that the procedure will result in a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove the results. I am aware that cosmetic tattooing is not an exact science, but an art and I acknowledge that no guarantees have been made to me as to the results of the procedure. Ivey Artistry does not guarantee the success of removal and or corrective procedures due to the substantial number of variables that affect the success of such procedures. Client acknowledges counsel by a representative of Ivey Artistry as to the probability of success of such procedures. I have read and understand the contents of each paragraph above. I have received no unrealistic warranties or guarantees with respect to the benefits to be realized from, or consequences of, the procedure(s).

Aftercare products must be approved by Ivey Artistry. If you have allergies to any specific ingredients, please notify your technician so he/ she can suggest an approved alternative. Sharing aftercare products is not allowed as it can result in cross-contamination.

All my questions have been answered to my satisfaction, I have enough information on which to base an informed consent to the self-elected procedure(s) described in my price quote. I accept full responsibility for the decision to have this cosmetic tattoo application procedure.