Medical Assessment Form

A medical assessment form is required to ensure your safety during a permanent makeup procedure. It helps identify any health conditions, allergies, or medications that may affect the treatment, healing process, or overall results. This information allows me to tailor the procedure and minimise any potential risks or complications.

Please complete your medical form at least 48 hours before your scheduled appointment.

This allows me sufficient time to review it and address any important details beforehand. Without a completed form, I am unable to proceed with your appointment.

If the form is completed on the day of your appointment, it will reduce the time available for your session. Additionally, if it’s not submitted on time before your in-person consultation, we won’t have enough time for the pre-draw—the most exciting part of your consult!

Contraindications

While permanent makeup is great for most people, some individuals are not suitable for these treatments. Please read the following permanent makeup contraindications carefully, to evaluate if you are an eligible candidate.

No Exceptions:

These conditions are absolute contraindications, meaning permanent makeup should not be performed under any circumstances:

  • Pregnancy: The procedure is not advised during pregnancy due to potential risks.

  • Active Skin Conditions:

    • Psoriasis, eczema, acne or dermatitis in the treatment area.

    • Open wounds, sunburn, cuts, or sores in the area.

  • Keloid Scarring: Clients prone to keloid formation should not undergo permanent makeup.

  • Accutane in the last 12 months: Clients skin is too sensitive to undergo a permanent makeup procedure.

  • Active Infections:

    • Cold sores, herpes simplex, or any localised infection in the area.

    • Systemic infections (e.g., flu, COVID-19).

  • Blood Disorders:

    • Hemophilia or other clotting disorders.

    • Conditions causing excessive bleeding.

  • Allergic Reactions: Known allergy to pigments, numbing agents, or other materials used during the procedure.

  • Cancer Treatment: Currently undergoing chemotherapy or radiation.

  • Severe Anxiety or Phobias: Clients living with trypanophobia, dysmorphophobia or hemophobia.

Exceptions with Additional Consent:

In some cases, permanent makeup may still be possible with additional consent and/or approval from your doctor:

  • Autoimmune Disorders:

    • Lupus, rheumatoid arthritis, or other conditions that could affect healing or immune response.

  • Diabetes: Particularly uncontrolled diabetes, as it affects healing and increases the risk of infection.

  • Blood Thinners: May require temporary discontinuation with a doctors consent.

  • Heart Conditions: Clients with pacemakers or other serious heart issues.

  • Severe Allergies: History of anaphylaxis or severe allergic reactions.

  • Thyroid Disorders: Conditions like hypothyroidism or hyperthyroidism, which may affect pigment retention.

  • Epilepsy: Clients prone to seizures may require clearance to ensure safety during the procedure.

  • Recent Surgery: Clients recovering from surgery in or near the treatment area, 6-12 months healing is advised.

  • Immunosuppressive Therapy: Clients on medications like corticosteroids or post-transplant medications.

Eligible Based on Individual Cases

  • Clients with a dark/discoloured pre-existing permanent makeup: The old work needs to be light enough in order to work over it, especially when creating hair strokes. We kindly ask clients with previous work to send clear, makeup-free photos of the area to be treated, this will help us assess whether removal is necessary before proceeding.