I understand that a certain amount of discomfort is associated with this procedure and that swelling, redness and bruising may occur.  I understand that sun, tanning beds, pools, some skin care products and medications can affect my permanent makeup. I will disclose to all skin care professionals or medical personnel about my permanent makeup procedures, especially MRI procedures.   I accept the responsibility to explain to my technician any desires for specific color, shape, and/or position for any procedure done today.  I understand that implanted pigment color may slightly change or fade over time due to circumstances beyond control and that I will need to maintain the color with future applications. I understand a touch up may be REQUIRED to complete the process.  I acknowledge that the proposed procedure(s) involve risks inherent in the procedure and have the possibilities of complications during and/or following the procedures such as infection, misplacement, pigmentation, poor color retention and hyper-pigmentation.  I have been given an estimate of the cost of the procedure. It is REQUIRED that a touchup appointment be scheduled 8-10 weeks after your initial visit to complete the freckles process. **THE INITIAL TOUCH UP PRICE IS AN ADDITIONAL FEE**. I understand there are no refunds for the elective procedure(s). I understand that any deposit made towards said procedure(s) will NOT be refunded if I choose to cancel my procedure for any reason. It is recommended that a yearly touch up be maintained between 24-36 months thereafter. I understand that ALL touchup appointments are an ADDITIONAL CHARGE. Possible Risks/Hazards/Complications: PAIN: There could be pain even after the topical anesthetic has been used. Anesthetics work better on some people than others. INFECTIONS: Infection is very unusual. Less than 0.25% of the population has an allergic reaction. The areas treated must be kept clean and only touched with freshly cleaned hands. See "After Care" for instructions. UNEVEN PIGMENT: This can be a result of poor healing, infection, bleeding, or other causes. Your follow up appointment will likely correct any uneven appearances. ASYMMETRY: Every effort will be made to avoid asymmetry, but our faces are asymmetrical and adjustments may be needed during the follow up session to correct any unevenness. EXCESSIVE SWELLING/BRUISING: Some people bruise and swell more than others. Ice packs may help the bruising and swelling. It typically disappears within 1-5 days. Bruising or swelling may not occur. ANESTHESIA: Typical anesthetics are used for numbing the area to be tattooed. Lidocaine, Prilocaine, Benzonecaine, Tetracaine Epinephrine in a cream or gel form are typically used. If you are allergic to any of these please inform your technician immediately. MRI: Because pigments used in permanent cosmetic procedures contain inert oxides, a low level magnet may be required if you need to be scanned by an MRI machine. You must inform your technician of any tattoos or permanent cosmetics. ALLERGIC REACTION: There is a small possibility of an allergic reaction. You may take a 5-7 day patch test to determine this. I am over the age of 18, am not under the influence of drugs or alcohol and desire freckles to be performed. The general nature of cosmetic tattooing as well as the specific procedure to be performed has been explained to me. **   I have been informed of the nature, risks and possible complications and consequences of permanent skin pigmentation. I understand the permanent skin pigmentation procedure caries with it known and unknown complications and consequences associated with this type of cosmetic procedure, including but not limited to: infection, allergic reaction, scarring, inconsistent color, and the spreading, fanning or fading of pigments. I understand the actual color of the pigment may be modified slightly, due to the tone and color of my skin. I fully understand this is a tattoo process and therefore not an exact science, but an art. I request the Freckles procedure and accept the permanence of the procedure as well as the possible complications and consequences of the said procedure. I understand that while this is sometimes referred to as semi-permanent in nature, due to each Individual's reaction to pigment, the length of time pigment is present cannot be guaranteed. In some cases, pigment will be permanent. *   I understand that if I have any skin 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 these potential adverse changes may not be correctable. * I have reviewed pre and post procedure instructions and I will strictly adhere to such instructions. I understand that my failure to do so may jeopardize my chances for a successful procedure. If I am on any medication for depression or any other mood altering prescription, I will advise my technician. * I understand that taking of before and after photographs of the said procedure are a condition of such procedure. I certify I have read and agreed to each of the above paragraphs and have been explained to my full understanding this consent and procedure process. I accept full responsibility for the decision to have the cosmetic tattoo work done. *   Office Policies: I agree to BR Brows and Beauty's cancellation and etiquette policies. I understand that a $100.00 dollar Non Refundable deposit is required to secure my initial appointment. I understand that a 48-hour notice is required for all cancellations! If you Do Not Cancel within 48hrs to your scheduled appointment time, For ANY REASON a fee of $100.00 will be automatically charged to the card on file. It is REQUIRED that all Clients have a card on file (please provide card info below). If a client does not show for an appointment or does not give proper notice after the second time, the next appointment is REQUIRED to be paid in full. If a client comes in for a pre booked service and decides to decline getting said procedure done, you are required to still pay the Full Service Fee. Clients who do not confirm their appointments through our reminders or confirm through text and phone calls will be removed, and replaced with a client on the cancellation list and charged the cancelation fee. Additionally, children under the age of 18 are NOT permitted in the office. I understand that by violating office policies, BR Brows and Beauty has the right to refuse service or charge me, the client, a fee (stated above). Non-Refundable Deposit Consent: Please read and check the box below. The undersigned, hereby agree to pay BR Brows + Beauty the amount of $100.00 as a NON-REFUNDABLE DEPOSIT in order to book Freckles. The undersigned, acknowledges, understands, and agrees that if he/she chooses to cancel said appointment at any point in time after making said deposit, THAT ALL DEPOSITS AND PAYMENTS MADE TO THAT POINT SHALL BE FORFEITED WITH NO REFUND OFFERED. The undersigned have been informed of this policy verbally, and consent to paying the $100.00 Non-Refundable deposit. The undersigned, acknowledges that there are no exceptions in which BR Brows + Beauty would refund said Non-Refundable deposit. The undersigned acknowledges, understands, and agrees that said deposit is NOT a credit, and that Deposits made are NOT transferable to other clients. By signing below, the undersigned, acknowledges, understands, and agrees to BR Brows + Beauty’s Non-Refundable Policy. I understand and accept BR Brows + Beauty's Non-Refundable Deposit Policy. * * *