Permanent Makeup Consent Form
Comprehensive consent form for permanent makeup procedures including lip blush, eyeliner, and brow tattooing. Covers all risks and aftercare requirements.
Last updated: April 2026
Researched by the CheckinPulse Research Team
Use This Form Digitally
Paper forms work, but digital forms work better. Here is what you get when you use this template on CheckinPulse:
Clients fill out on their phone (no app needed)
Scan a QR code or tap a link — works on any device
E-signatures with legal timestamp
IP address, timestamp, and audit trail on every signature — valid in all 50 states under the E-SIGN Act
Submissions go straight to your dashboard
No more clipboards, filing cabinets, or illegible handwriting
PDF waivers stored for 7 years
Encrypted, searchable, and accessible anytime on paid plans
Form Preview
This is what your clients will fill out. 17 fields, mobile-friendly.
Permanent Makeup Consent Form
All fields marked with * are required
Consent / Waiver Language
This waiver text is included at the bottom of the form, above the signature field.
I consent to the permanent makeup procedure described above. I acknowledge this procedure involves depositing pigment into the dermal layer of the skin and is semi-permanent to permanent in nature. Risks include but are not limited to: infection, allergic reaction to pigments or numbing agents, scarring, keloid formation, asymmetry, color change or migration, and unsatisfactory results. I understand that healing takes 4-8 weeks and final results depend on proper aftercare. Touch-up sessions may be needed. I have disclosed all medical conditions, medications, and allergies. I release the provider from liability for outcomes within the normal range of expected results.
Legal References
The federal law that makes electronic signatures on consent forms and waivers legally equivalent to handwritten signatures in all 50 US states.
Frequently Asked Questions
Microblading is a type of permanent makeup, but a general PMU consent form covers more procedures — lip blush, eyeliner, areola restoration, scalp micropigmentation. The risk disclosures are similar, but a PMU form should address procedure-specific risks (e.g., cold sore activation for lip blush).
In most states, yes. Requirements range from a body art license to a specific cosmetic tattoo certification. Some states require health department inspections. Your consent form should reference your license and training to build client trust.
Lip blush can trigger cold sore outbreaks in people with the HSV-1 virus. Your consent form should ask about cold sore history and recommend antiviral medication (like Valtrex) starting 3 days before the procedure. If they didn't disclose their history and get a breakout, the consent form protects you.
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