About this template
A Permanent Make Up Consent Form is essential for any professional offering microblading, lip blushing, eyeliner tattooing, or other cosmetic procedures. This template allows beauty salon owners, permanent makeup artists, and aesthetic practitioners to securely gather vital client details, including contact information, date of birth, and comprehensive medical history.
Before beginning any cosmetic procedure, verifying a client's health status—such as existing skin conditions, allergies, and current medications—is critical for safe service delivery and managing liability. This form streamlines the client intake process by organizing all necessary permissions, risk acknowledgements, and policy agreements into a single digital step. Salons can use Doc2Form to instantly convert documents like this into a ready-to-use Google Form, ensuring a seamless experience for both staff and clients.
By collecting these acknowledgements ahead of time, practitioners protect their business, reduce day-of paperwork, and provide clients with a clear overview of aftercare and payment terms. It fosters transparency and trust from the very first interaction.
Key features
- Collect mandatory client consent and medical disclosures in advance
- Review allergies, skin conditions, and current medications safely
- Outline studio policies, cancellation terms, and payment details
- Fully customizable for microblading, lip tattooing, and scalp micropigmentation
- Mobile-friendly format for clients to complete on their own devices
Use cases
- Microblading and brow tattoo initial appointments
- Lip blushing and permanent eyeliner procedures
- Scalp micropigmentation client onboarding
- Aesthetic clinic liability and waiver collection
What this form collects
- Client Full Name (Short answer)Enter your first and last name as it appears on your government-issued ID.
- Date of Birth (Date)Please enter your date of birth.
- Home Address (Paragraph)Provide your current street address, city, state, and zip code.
- Phone Number (Short answer)Enter the best phone number to reach you regarding appointment updates.
- Email Address (Short answer)We will send your appointment confirmation and aftercare instructions here.
- Requested Procedure (Dropdown)Select the permanent makeup service you are scheduled for today.
- Medical History & Health Conditions (Checkboxes)Please select any conditions that currently apply to you.
- Known Allergies & Current Medications (Paragraph)List any topical allergies, sensitivities to anesthetics (lidocaine), or medications you take regularly.
- Policies & Payment Terms (Multiple choice)Do you understand our cancellation policy, deposit requirements, and that touch-up sessions are billed separately unless specified?
- Acknowledgement of Risks & Aftercare (Multiple choice)Initial or confirm that you have been informed of the procedure risks, healing process, and mandatory aftercare instructions.
- Client Signature and Date (Short answer)Please type your full legal name to serve as your digital signature confirming all provided information is accurate.
FAQ
What is the primary purpose of this consent form?
It ensures that clients acknowledge the risks of permanent cosmetic procedures, disclose relevant medical history, and agree to studio policies before any work begins.
Can I customize the medical history questions?
Yes. Once you load this template into your Google Forms account, you can freely add, remove, or edit any questions to match your specific studio requirements.
How do clients fill out this form?
You can email the Google Form link to clients ahead of their appointment or have them scan a QR code at your front desk to complete it on their phone.
Is this form suitable for all types of cosmetic tattooing?
Yes, it can be easily adapted for microblading, powdered brows, permanent eyeliner, lip tattoo, or paramedical repigmentation services.
How does Doc2Form help me set this up?
Doc2Form instantly transforms your existing PDF or Word consent documents into fully editable Google Forms in just a few seconds.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.