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HENNA CONSULTATION FORM

By submitting this form, you agree to have hair, skin, or body services during the pandemic.

Address

Phone Number

Skin Type
Do you experiece
Have you received any Eyebrow tattooing or Microblading recently?

I understand that my Henna Brow procedure is temporary and will potentially be staining my skin immediately, up to 1- 3 weeks depending on skin type, and will start fading as soon as 24 hours after the procedure is complete. 


I understand that results vary with everyone. Overall skin conditions and aftercare with ultimately affect the retention of the Henna Brow results.


I release Lena Taryanik from any and all liability related to the subject of the procedure, expecting instances involving gross negligence.

 
I understand that in the rare occasions there are risks associated with the procedure such as skin irritation and discomfort which might occur. 


I agree to follow the care and maintenance instruction provided to me by the technician, and that if any follow up care is required due to my own mistake or negligence, or failure to follow these instructions, it will be at my own expense and risk. 


I understand that the henna will fade immediately if I get the brows wet within the first 24 hours. This includes showering, steam, swimming, and sweating. The results will fade faster if any form of oils, and/or alcohol are used on or near the brows. 

 
I understand that if I have any scarring in, or near my brows due to microblading, eyebrow tattooing, facial piercings, previous natural accidents, the henna may not adhere to the scar tissue. 

 
I understand that if I have any open wounds, lesions, acne, abrasions, etc in the brows, the Henna application may cause irritation, itching, burning, and discomfort. 

 
I understand there may be residual staining left on the skin following the Henna Brow process. This will fade and go away in a short amount of time. 

 
I understand that while every attempt will be made to provide me with my chosen color, everyone’s hair and skin  absorbs color differently, and my final result may not be the color I initially wanted.

Thanks for submitting!

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