microblading

Ready to have incredible eyebrows? If you’d like to book your first microblading appointment, we need to find out if you’re a candidate for this procedure. Fill out the form below and hit Submit, then someone from our office will contact you to schedule your consultation. We know, we know, it’s kind of long! But 1) safety first and 2) getting the boring stuff out of the way first means appointment day will go much more quickly.

 
 
Name *
Name
Phone *
Phone
Date of Birth
Date of Birth
Are you currently on medications?
Pregnant or Nursing?
Alcohol or caffeine in the last 24 hours?
Prone to cold sores or fever blisters?
Laser of chemical peels in last 30 days?
Allergic to latex?
Previous permanent cosmetics or tattoos?
Bruise easily or keloid skin?
Use Accutane or Retin-A?
Allergic or sensitive to metals?
Wear contact lenses?
Do you exercise often?
Do you have problems healing?
Do you have oily skin?
Do you use tobacco or nicotine producst?
Do you have sensitive skin?
Are you sensitive to creams or lotions?
Do you take Niacin?
Do you take fish oil supplements?
Do you tan (in the sun, a bed, or spray)?
Are you undergoing radiation?
Are you allergic to hair dyes?
Are you allergic to any makeup?
Are you allergic to over-the-counter numbing agents?
Are you currently menstruating?
Are you allergic to nitrile?
Do you have light sensitivity?
Are you allergic to plastic?
Do you have dry eyes?
Do you consume Aspirin often?
Do you suffer from fainting spells or get dizzy often?
Do you use eyelash growth serums?
Do you bleede excessively from minor cuts?
Does your skin have hyper- or hypo-pigment?
Do you use Botox or facial or lip fillers?
Do you take Vitamin E?
Do you take Ibuprofen daily?
If you answered YES to any of the above questions, please provide comments here. A YES answer to any of the above does NOT mean that you are not a candidate for permanent cosmetic service.
Please list all medications you are currently taking.