Please read, sign, and submit before arriving to your appointment

REQUIREMENTS BEFORE EYEBROW MICROBLADING:

  • No Botox treatments should be done 3 weeks prior or 4 weeks after procedure

  • No chemical peels 60 days before or after procedure (brows will peel quicker due to chemicals traveling under the skin)

  • No Retinols/Retin-A or other anti-aging/acne creams, or serums containing acids as these will fade brows prematurely

  • Do not work out or sweat heavily the day of the procedure (or 2 weeks after)

  • Do not tan or have a sunburned face the day of the procedure

  • No waxing or tinting 3 days before procedure

  • Stop taking aspirin, niacin, vitamin E, fish oil, CoQ10 and ibuprofen 48 hours before procedure

  • No alcohol or caffeine 24 hrs before procedure

MICROBLADING CONTRAINDICATIONS

MICROBLADING IS NOT RECOMMENDED FOR ANYONE WHO IS OR HAS THE FOLLOWING:

  • Sick with cold, flu, or sinus/respiratory infection (please reschedule your appointment and stay home to recover)

  • Skin irritations including: sunburn, rash, eczema, shingles, acne, or psoriasis near the treated area

  • Pregnant or nursing

  • Under age 18

  • Had Botox within 3 weeks from scheduled appointment

  • Used Accutane in the past year

  • Diabetes

  • Epilepsy

  • Undergoing chemo

  • Prone to keloid scarring

  • Pacemaker or major heart problems

  • Had an organ transplant

  • Viral infections and or diseases

  • Transmittable blood disease, HIV or Hepatitis

MEDICATIONS TO AVOID BEFORE MICROBLADING

The following medications are known to affect the blood clotting process. Therefore, these medications need to be avoided (7) seven days prior to your procedure.

A

Actron Advil Aggrenox Aleve Alka-Seltzer Anacin Anaprox Anexsia w/Code Anodynos Ansaid A.P.C. Artrotec A.S.A. Ascriptin Aspergum Aspirin Axotal

B

B-A-C Bayer Bexophene Bextra Brilinta Buffered Aspirin Buffaprin Bufferin Buffinol

C

Cama Arthritis Strength Cataflam Celebrex Cheracol Capsules Clinoril Clopidogrel Combunox Congespirin

D

Damason-P Darvon Dasin Daypro DHC plus Dia-Gesic Diclofenac Dipryridamole Disalcid Dolabid Dolprin #3 Doxaphene Dristan

E

Easprin Ecotrin Emagrin Forte Empirin Equagesic Equazine Etodolac Excedrin

F

Feldene Fenoprofen Fiogesic Fiorgen PF Fiorinal 4-Way Cold Tablets

G

Ginko Biloba Gemnisyn

I

Ibuprofen Indocin Indomethacin

K

Ketoprofen Ketorolac

L

Liquprin Lodine Lortab

M

Magnaprin Marnal Measurin Meclofenamate Mefenamic Meloxicam Meprobamate Midol Mobic Momentum Motrin

N

Nabumetone Naprelan Naprapac Naprosyn Naproxen Norgesic Nuprin

O

Orudis Oruvail Oxaprozin

P

Pabalate P-A-C Percodan Persantine Persistin Piroxican Plavix Pletal Ponstel Prevacid w/ Naprapac Presalin Profen

R

Relafen Robaxisal Roxiprin Rufen

S

Salsalate Saleto Salocol Soma Compound Sprix Nasal Spray St. Joseph Sulindac Supac Synalgos-DC

T

Talwin Ticagrelor Ticlopidine Ticlid Tolectin Tolmetin Toradol Trental Trigesic Trilisate

U

Ultraprin Uni-Pro

V

Vanguish Vicoprofen Vimovo Vitamin E Voltaren

Z

Zipsor Zorpin

I have read and understand the information provided to me on this form and understand it is my responsibility to come to my appointment prepared accordingly.

Thank you! Your form has been submitted.

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