book a cosmetic tattoo Name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone (###) ### #### Preferred method of communication * Phone Text Email Is this a: * 1st Time Appointment Touch Up Appointment Rework of existing permanent makeup Would you like to add on Microneedling for $150 ($50 off!) Yes What would you say your skin type is? * Oily Mature Dry Combination Acne Prone Sensitive Are you currently on any blood thinners? * Yes No If Yes, please list: Preferred procedure * Lip Blush Tattooing Powder Ombre Brown Tattoo Lash Enhancement Tattoo LIFT Saline Tattoo Removal Microneedling Are you prone to cold sores? * If yes, please consult with your doctor before booking to begin anti-viral medication 5 days before your appointment as well as 5 days post-procedure Yes No Are you currently taking any medications or undergoing any medical treatments that might affect the healing process? * Yes No If Yes, please list: Do you have any existing medical conditions, especially those related to lips and skin, that I should be aware of? * Yes No If Yes, please list: Have you had any recent dental work or lip injections that might impact the tattooing process? * Yes No If Yes, please list: Prone to Keloid scarring? * Yes No Would you like a consultation before your session? * Yes No Do you have any images of your anatomy that you can send in advance? Please email them to llbpiercing@gmail.com Have you had permanent makeup before? What is your desired result? * We require a 50% deposit via e-transfer once a day and time has been confirmed. Cash preferred upon completion of procedure Thank you!
