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Patch Test CONSENT FORM

Patch Testing involves placing small amounts of the substance against the skin and affixing
them in place for 48-72 hours. The testing site is then monitored for local reaction. Potential
adverse events include rash at the site, infection, or delayed skin reactions. 
There is a possibility of an allergic reaction to pigments. Pigment contents are iron oxide,
titanium dioxide, isopropyl alcohol, glycerin, ethanol, and distilled water. 
A patch test is advisable however it does not ensure a client will not have an allergic reaction. 


I CONSENT THE PATCH TEST:                                                       
I have received a patch test on the date below. The patch test has been received and it releases
Posh Beauty Artistry, and assistant(s) from any liability related to any allergies or other reaction
to applied tattoo/permanent makeup pigments. I have been informed that reactions can occur at
any time in the future. Sun exposure can also cause a reaction with the pigments (colors).


I WAIVE THE PATCH TEST:
I release Posh Beauty Artistry, and assistant(s) from any liability if I develop an allergic reaction
to the tattoo/permanent makeup pigments during or after tattoo/permanent makeup
procedure(s). 
I automatically release the technician and assistants from liability if I develop an allergic reaction
to the pigment.

Thanks for submitting!

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