Name * First Name Last Name Date of Birth Gender * Female Male Other Age * Mobile Number * Email Address * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Occupation * Are you currently using any medications? * Yes No Are you able to use topical anesthetics? (lignocaine, tetracaine, prilocaine, epinepherine) * Yes No Do you have ANY allergies? * Yes No If so; please list all and any allergies. Are you pregnant, planning pregnancy or breastfeeding? * Yes No Do you have oily skin? * Yes No Have you had your eyebrows tattooed before? * Yes No Do you have any health concerns? * Yes No Are you iron deficient or anemic? * Yes No Are you prone to keloid scarring? * Yes No Please take a FULL FACE, LEFT BROW & RIGHT BROW image with sufficient lighting and send via email or text. Please select where you are sending the images. * Email - salon@archbrowaesthetics.com Text - 0400 396 727 I have thoroughly read and understood the information section and have answered each question truthfully * I Accept Thank you for your submission, a team member from Arch Brow Aesthetics will contact you in regards to cosmetic tattooing. eyebrow TattooConsultationPlease ensure you answer all questions truthfully and to the best of your knowledge.
