Client Consent Form

Medical Consent

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Full Name *

Email Address *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Are you 18 years old or over? *

I understand that I cannot go on holiday or be in direct sunlight for 21 days after my permanent make up appointment. *

I Understand

I understand that I cannot use or have been on holiday for at least two weeks prior to my appointment. If you have visible sun damage or an extreme tan I will not be able to tattoo you And this will result in the booking being reschedule and A new deposit will be required. *

I Understand

I understand that I cannot use sunbeds for two weeks post appointment. *

I Understand

Are you pregnant or breastfeeding? *

Are you allergic to lidocaine? *

Are you allergic to nickle? *

Are you allergic to glycerin? *

Do you have any other allergies? *

If yes, what allergies do you have?

Do you have an artificial heart? *

Do you have epilepsy? *

Are you diabetic? *

Do you have haemophilia? *

Do you have any liver problems? *

Do you have Hepatitis? *

Do you have cancer? *

Have you undergone chemo therapy /Radiotherapy in the last six months? *

Do you have high blood pressure that is not controlled? *

Do you have any skin conditions in the area that is being tattooed? *

Are you on antibiotics currently? *

I understand that Antibiotics cannot be taken whilst you are in the healing process of permanent makeup. *

I Understand

Have you been treated for cancer in the last six months? *

I understand that I cannot have chemical peels for 28 days prior to my appointment and are not advised between session one and the 6-8 weeks top up *

I Understand

Do you have any Botox or fillers booked 28 days prior to your appointment? (Please be aware Botox must be carried out at least 2 weeks prior to any appointment and is not recommended between your first brow appointment and 6-8 weeks brow top up) *

Do you use retinol regular? ( please check all anti ageing products to see if they contain retinol/retinal) *

I agreed to arrive to my appointment 10 minutes early. ( Please ensure you arrive promptly and allow extra time for parking as there is no parking directly outside of the salon. We recommend parking just down the road on Grove Drive where there is a free car park. And walking up White Apron Street to the salon) *

I Agree

I agree to follow all my pre-treatment guidance and I understand that failure to do so will result in the appointment being rescheduled and a new booking fee would be required. *

I Agree

I understand that some clients will require additional retouches and If I do require any additional retouch appointments I am aware they will incur additional charges. *

I Understand

I Understand that I am required to book my own retouch appointment today. Please book this online now for 6-12 weeks after your first appointment. (Full instructions are included in your confirmation email). I understand tha If I do not book the complimentary service within this time frame I will be charged an annual top up fee if it falls outside of this timeframe. *

I Understand

I understand there is no guarantee of success or longevity to this treatment and every clients outcome will be different. *

I Understand

(Please or advised

I understand that if I have previous permanent makeup in the area Rebecca will be treating, I must have informed her of this, and had her assess the previous work via in person or photographs. *

I Understand

I understand that if I turn up to the appointment with previous ink in the same area being treated by Rebecca, and she cannot work over it, I will be turned away and charged full price for the loss of the appointment. *

I Understand

I understand that if I cancel my appointment within 72 hours or no show then you are required to pay the full amount of the appointment. *

I Understand

I agree to follow all the after-care advise provided to me and I Understand that if I do not follow the after-care this could lead to unwanted healed results such as patchiness, Colour discolouration, or even complete loss of the tattoo. Should this arise I understand that my complimentary retouch appointment would have to be cancelled and an additional charge of £100 would be required to rebook a larger slot for the area to be redone. *

I Agree

I understand that Rebecca owns all the rights to the photographs she takes and these can be used for promotional and marketing purposes. *

I Understand

Patch Test Wavier I waver the right to a patch test. I understand that a patch test for pigment does not guarantee that I will not have an allergic response at any time post treatment as well as anaesthetics. I am aware of that allergic response to pigment and anaesthetics is rare and accept all responsibility if allergic response occurs. A reaction can happen with or without a patch test on a very rare occurrence. *

I Understand

Conditions *

I have read and agree to Rebecca Batty PMU's

1. Our Contract with You
1.1 These Terms and Conditions govern the sale of Services by Us and will form the basis of the Contract between Us and you. Before paying a deposit, please ensure that you have read and understood these Terms. Please contact us if you have any questions.
1.2 A legally binding Contract between Us and you will be created upon Our acceptance of your deposit payment, indicated by your email Confirmation. Order Confirmations will be provided via Email and Text Message.

2. Booking Your Appointment
2.1 You can book an appointment via telephone, our website REBECCABATTYPMU.COM, or by contacting us via messenger on 07493 047547.
2.2 Your scheduled appointment is only reserved for 10 minutes. After this period, if you have not paid your Deposit Fee to secure your appointment, your reservation will be automatically cancelled without notice.
2.3 Once we have received your Deposit Fee, your scheduled appointment is confirmed. However, we reserve the right to amend or cancel your appointment at any time.

3. On Your Treatment Day
3.1 Please arrive on time prior to your booked treatment time. We reserve the right to refuse treatment to customers who are more than 10 minutes late. Your deposit will be forfeited, and the Contract will be Terminated. We may be able to book another date for you, but this will require a new Deposit Fee.
3.2 Ensure that you have followed the Pre-treatment Advice that you would have received. Including the following:

Do not wax, tint, or pluck your brows before treatment

Please avoid intense sun exposure and tanning one week prior to the procedure

Discontinue use of topical retinols, glycolic acid, and other chemical peel treatments at least 14 days before treatment

Do not take Aspirin, Ibuprofen, Niacin, or Vitamin E 48 hours before the procedure

Do not consume coffee, alcohol, or energising drinks/medication on the day of treatment and 48 hours before

Do not partake in any exercise that makes you sweat on the day of treatment
3.3 Appointments typically last around 3 hours, depending on your treatment. Babies and children cannot be present during the appointment. Please make necessary arrangements in advance.
3.4 We occasionally run behind schedule due to the nature of the treatments, so please take this into consideration when planning your day.

4. Subsequent Appointments
4.1 If you have booked in for a new Permanent Makeup treatment, you will need to book a 6–8 week top-up appointment via the online booking system.
4.2 Complimentary touch-up treatments, if needed, come at no additional cost to the original price. There is no obligation on us to offer a touch-up treatment. Rebecca will decide whether you need one. The initial treatment may be sufficient, but if you do need a touch-up appointment, you are only eligible for one free treatment for any one new treatment paid for in full, when booked in the correct time frame.
4.3 The purpose of a complimentary retouch treatment is to retouch healed areas lacking sufficient pigment, add a colour boost to faded areas, or fill in gaps after the initial treatment.
4.4 The timescale to receive a complimentary retouch is no later than 6–8 weeks after the date of the initial treatment. If, for any reason, you miss this appointment, a colour boost charge of £100 (up to 12 weeks) will apply.
4.5 Retouches after this point will be subject to our 12-month yearly colour boost prices.

5. Colour Boost Appointments
5.1 Permanent Makeup can last up to 1–3 years before starting to fade. Many factors contribute to fading (including aftercare, skin type, lifestyle, medication, and health). For this reason, top-ups are advised between 12–24 months to maintain colour vibrancy.
5.2 The degree of fading depends on factors such as sun exposure, skin type, and skin conditions. Some clients may need more frequent touch-ups than others.
5.3 The yearly colour boost treatments are singular sessions and do not include any free touch-ups.
5.4 Permanent makeup treatments may require more than two sessions. Additional sessions are not included in the original price and will be charged at the current rate listed on our booking system.

6. Services We Provide
6.1 The Services we provide are listed on our website: www.RebeccaBattyPMU.com
6.2 We reserve the right to vary the Services at any time or add additional Services not listed on the website.

7. Agreed Customer Obligations
7.1 Complete all pre-treatment consent forms accurately. Please contact us if you have any questions.
7.2 Make all requested payments on time to avoid Termination of the Contract.
7.3 Follow the pre-treatment advice.
7.4 Arrive on time for appointments.
7.5 Follow the aftercare advice.
7.6 By paying a Deposit Fee, you agree not to post any negative, defamatory, or slanderous comments or photographs on any social media platform including Facebook, Instagram, or TikTok regarding Rebecca Batty and Training, staff members, or students. If any client fails to adhere to this, they will be liable for any legal costs incurred in court proceedings brought against them.

8. Our Obligations to You
8.1 Perform the treatments to our best ability.
8.2 Keep your personal information private and securely stored for 7 years.
8.3 Use our best endeavours to provide you with an excellent experience, good customer service, and ongoing support where needed.

9. Charges, Payment, and Refunds
9.1 The price of our treatments is quoted at the time of booking.

10. Booking Fees
10.1 No appointments can be confirmed without a paid deposit.
10.2 Deposit Fees are charged at £100 per booking and are deducted from the treatment price.
10.3 Deposit Fees are non-refundable.
10.4 Treatment Fees must be paid in full at the first appointment. Nothing is payable at the 6–8 week top-up appointment.

11. Offers, Discounts, and Vouchers
11.1 Offers and discounts are valid for 7 days from the date of the quote.
11.2 Vouchers and e-vouchers are non-refundable. The physical voucher or email must be presented at the time of use. Vouchers are valid for 12 months from the date of purchase.

Gift vouchers cannot be used as booking deposits.

Gift vouchers cannot be exchanged for cash.

If the total value is not used, no change or credit note will be given.

We do not accept liability for lost or damaged vouchers; they are void and unredeemable.
11.3 If you have claimed a voucher from any of our ads, it must be claimed and booked through the company. Vouchers cannot be applied to existing bookings or ones made directly with Rebecca.

12. Intellectual Property Rights
12.1 Pictures may be taken during your treatment for insurance and reference purposes and may be used by Rebecca Batty for marketing on social media and our website.
12.2 All intellectual property rights in or arising from the Services will be owned by us.

13. How We May Use Your Personal Information
13.1 We will use your personal information to:

Provide the Services

Process your payment

Inform you about similar services (you may opt out at any time)
13.2 We will process your personal information in accordance with our Privacy Policy, which forms part of this Contract.

14. Our Responsibility for Loss or Damage Suffered by You
14.1 We are responsible for foreseeable loss or damage caused by our failure to comply with these terms or to use reasonable care and skill.
14.2 We do not exclude or limit liability where it would be unlawful to do so.
14.3 We are not liable for business losses. Our services are for domestic and private use only.
14.4 All treatment terms are outlined in your consent forms, which must be read, signed, and agreed to before your treatment.
14.5 We are not liable for any infections resulting from poor aftercare.

15. Cancellation, Termination of Appointments, and Rescheduling
15.1 If you cancel your appointment, your Deposit Fee is non-refundable and will be forfeited.
15.2 You may reschedule your appointment once via the online booking system at least 14 days in advance. After this period, a new deposit will be required.
15.3 Complimentary retouch appointments (scheduled 6–8 weeks after the initial appointment) cannot be rescheduled. If you miss this, it will be cancelled and a new retouch appointment will be charged as per Clause 4.4.
15.4 We reserve the right to refuse treatment to clients who arrive more than 10 minutes late. The deposit will be forfeited and the contract terminated.
15.5 We reserve the right to refuse treatment to clients who are under the influence of drugs, alcohol, or medication that impairs decision-making.
15.6 We also reserve the right to refuse treatment to clients with unrealistic expectations, those who pressure artists to operate outside professional standards, or clients who behave aggressively. In such cases, deposits are non-refundable.
15.. If you cancel your appointment within 72 hours or no show then you are required to pay the full amount of the appointment. Failure to do so will result in court proceedings.

16. Events Outside Our Control
16.1 We will not be liable for delays or failures due to events beyond our reasonable control, including any changes related to COVID-19.
16.2 If such an event occurs:

We will notify you as soon as reasonably possible

Our obligations will be suspended and extended for the duration of the event

A new date for performance of the Services will be arranged

17. General
17.1 Assignment and Transfer

We may assign or transfer our rights under this Contract but will notify you.

You may not assign your rights without our written consent.

17.2 Variation

Any changes must be in writing and signed by both parties.

17.3 Waiver

Failure to enforce any term does not waive our right to enforce it later.

17.4 Severance

If any part of the Terms is deemed unlawful, the rest remain valid.

17.5 Third-Party Rights

This contract is between you and us. No third party may enforce it.

17.6 Governing Law and Jurisdiction

This Contract is governed by English law and subject to the exclusive jurisdiction of the English courts.

Todays Date *

Signature (Print Name) To agree to the Terms & Conditions *

You consent that all the information you provided and accurate. If anything changes, please contact Rebecca Batty to rectify any issue!

Are you 18 years old or over?

Yes No

Do you agree not to consume alcohol or caffeine (coffee, tea, energy drinks, fizzy drinks) 48 hours prior to your appointment?

Yes No

I understand that I cannot go on holiday or be in direct sunlight for 21 days after my permanent make up appointment.

I Understand

I understand that I cannot use sunbeds for two weeks post appointment.

Yes No

Are you pregnant or breastfeeding?

Yes No

Are you allergic to lidocaine?

Yes No

Are you allergic to nickle?

Yes No

Are you allergic to glycerin?

Yes No

Do you have any other allergies?

Yes No

If yes, what allergies do you have?

Do you have an artificial heart?

Yes No

Do you have epilepsy?

Yes No

Are you diabetic?

Yes No

Do you have haemophilia?

Yes No

Do you have any liver problems?

Yes No

Do you have Hepatitis?

Yes No

Do you have cancer?

Yes No

Have you undergone chemo therapy /Radiotherapy in the last six months?

Yes No

Do you have high blood pressure that is not controlled?

Yes No

Do you have high blood pressure that is not controlled?

Yes No

Do you have any skin conditions in the area that is being tattooed?

Yes No

Are you on antibiotics currently?

Yes No

I understand that Antibiotics cannot be taken whilst you are in the healing process of permanent makeup.

I Understand

Have you been treated for cancer in the last six months?

Yes No

I understand that I cannot have chemical peels for 28 days prior to my appointment and are not advised between session one and the 6-8 weeks top up

I Understand

Yes No

Do you use retinol regular? ( please check all anti ageing products to see if they contain retinol/retinal)

Yes No

I Agree

I agree to follow all my pre-treatment guidance and I understand that failure to do so will result in the appointment being rescheduled and a new booking fee would be required.

I Agree

I understand that some clients will require additional retouches and If I do require any additional retouch appointments I am aware they will incur additional charges.

I Understand

I Understand there is no guarantee of success or longevity to this treatment and every clients outcome will be different.

I Understand

I understand that Rebecca owns all the rights to the photographs she takes and these can be used for promotional and marketing purposes.

I Understand

Patch Test Wavier
I waver the right to a patch test. I understand that a patch test for pigment does not guarantee that I will not have an allergic response at any time post treatment as well as anaesthetics. I am aware of that allergic response to pigment and anaesthetics is rare and accept all responsibility if allergic response occurs. A reaction can happen with or without a patch test on a very rare occurrence.

I Understand

I have read and agree to Rebecca Batty PMU's Terms & Conditions

Message

Pre Treatment and Aftercare