Free TemplateBeauty & Aesthetics

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

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This is what your clients will fill out. 17 fields, mobile-friendly.

Permanent Makeup Consent Form

All fields marked with * are required

Jane Doe
jane@email.com
(555) 123-4567
Date
Text
Phone
Lip Blush
Yes
Diabetes, hemophilia, HIV, hepatitis, autoimmune conditions...
Blood thinners, Accutane, immunosuppressants...
Numbing cream, pigments, latex, metals...
Yes
Yes
I understand this is a semi-permanent to permanent procedure*
I understand healing takes 4-8 weeks with proper aftercare*
I have reviewed and accept the aftercare instructions*
Sign here
Submit Form

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.

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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