HEALTH INFORMATION Are you pregnant, planning pregnancy, or breastfeeding?
Are you epileptic, or experience fainting spells or seizures?
Do you have allergies to pigments or makeup?
Do you experience post-inflammatory hyper-pigmentation?
Do you have undiagnosed rashes on the eyebrow/ forehead region?
Do you have transmittable blood conditions? (Hepatitis, HIV, etc)
Have you taken accutane within one year?
Have you had your eyebrows tattooed before?
Do you often sweat excessively (exercising), spend a lot of time in the sun or chlorinated/ salt water?
Are you able to use topical anesthetics? (lidocaine, tetracaine, prilocaine, epinephrine)
Are you taking daily blood thinning medications?
Do you have active skin conditions or diseases on the eyebrow/ forehead region? (eczema, psoriasis, rosacea, etc)
Do you have active skin cancer in the eyebrow/ forehead region?
Do you suffer from keloid scarring?
Do you have mitral valve disorder?
Have you have radiotherapy or chemotherapy within 42 days of the possible procedure date?
What is your ideal results after the eyebrows are fully healed?
Would you prefer to have the treatment completed in one session?
How would you like our PMU technician to reach out to you in response to your consult form?
Please attach three clear images (one frontal, and a side profile of each eyebrow) with no makeup on (must be taken with sufficient lighting). Upload supported file (Max 15MB ) I have read and answered the questions on this form to the best of my ability. I understand that Studio Masami is not liable for providing incorrect recommendations if the wrong information was provided.
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Your online consultation form has been successfully submitted! Our cosmetic tattoo technician will get reach out to you via your preferred contact selection within 72 hours.
