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Pre-Assessment Form

Please fill out this form so we can assess if the procedure you seek (permanent makeup, lashes, skin,...) is the best option for you.

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Are you pregnant/nursing?
Do you have any tattoos?
Do you have any allergies?
Are you allergic to any metals (Nickel, etc.)?
Are you prone to developing keloids?
Are you allergic to any topical antibiotics/anesthetics?
Have you got any semi-permanent makeup procedre before?
Are you taking any medcation, including immunosuppressants, anti-inflammatories, or steroid?
How would you define your skin?
Have you sunbathed or used a tanning bed in the last 2 weeks?
Are you taking any mediations, including vitamins, or Aspirin, etc.?
Do you currently have any blemishes, cuts, irritation, or infections on your face?
Do you have any moles, raised areas, prior or current piercings in the projected procedural area?
Do you have Eczema, Psoriasis around the eyes, or have you had a recent eye surgery?
Do you have diabetes?
Do you have a vascular or cardiovascular condition?
Have you ever been diagnosed with cancer? If yes, are you currently getting any treatmnent for the same?
Have you had any recent medical procedures?
Have you got lash extensions in the last 14 days?
Have you received Botox injections in the last 30 days?
Do you use skincare procedures with Retin-A, Retinols, or Vitamin A?
Have you had any facial procedures in the last 30 days?
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Attractive Mature Woman
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Natural Beauty
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Female Soccer Coach

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