Lip Blushing Herpes Simplex Disclaimer

Clients who have suffered from cold sores (Herpes simplex 1) can experience symptoms of the infection after treatment to the lips. Many are not aware that they are a carrier of this virus, as signs are not always visible until it is triggered. We HIGHLY Recommend all clients undergoing Lip Blushing to use Antiviral medication pre and post their procedure. Medications such as Valtrex : (should be started 4/5 days prior to your appointment and 3-4 days after the treatment). Cold sores are a typical reaction in permanent makeup of the lips. I am fully aware that permanent make up causes a cold sore outbreak reactivation in up to 90% of the cases.

Name

First Name

Last Name

Phone

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Do you have a known history of cold sores?

I understand that it is my sole responsibility to obtain an Antiviral prescription from my primary care physician in order to be properly prepared for my lip blushing appointment. I acknowledge and understand that if I choose not to obtain said prescription it can directly effect my results. I also acknowledge that my provider will not be heald accountable if I do break out with a cold sore post procedure.

I Agree

What can happen if I choose not to take an Antiviral Script?

* Poor Pigment Retention * Infection * Excess Scar Tissue * Cold Sore Outbreak * Undesirable Outcome

I Agree

I understand that if I am not properly prepared for my appointment, my provider has the right to refuse service. I acknowledge and understand that if service is refused for said reason I am responsible to pay a Cancelation fee of $100.00.

I Agree

Lip Blushing Herpes Simplex Disclaimer

Hours of Operation

BR Brows + Beauty

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