Minnesota Brow Lash Studio & Academy Registration Form

Appointment Reservation Form

Fill out the form to reserve your appointment
Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail
Phone Number

Area Code Phone Number
Detail of your service request
Date-Time-Price-Specific Request - Who was the staff did you talk to if any?
Are you an existing customer?

Yes No
How do you hear about us?
Please note that if any of the following is true, you are unfortunately, not a candidate for Permanent Makeup or Microneedling. These are called contraindictions.
• People with diabetes.
• Women who are pregant or lactating.
• People with glaucoma or taking blood thinning medication.
• People with skin diseased such as psoriasis, eczema and undiagnosed rashes or blisters on the Site that is to be treated.
• People with allergies to makeup or colors.
• People with easily triggered postinflammatory hyperpigmentation are not good candidates.
• People with transmittable blood conditions like HIV or Hepatitis.
• People with active skin cancer in the area to be tattooed
• People who are hemophiliac.
• People who have healing disorders, uncontrolled high blood pressure or had mitral valve disorder.
• People on any skin medication such as ro-accutaine, steroids which thin and oversensitive the skin.
You can view the full list of circumstances that would mean you are not a good candidate for microblading here.
Fee Required

Permanent Make-up Fee $ 50.00

Quantity

Total $ 0.00
- YOU MUST BE 18 yrs of age or older
- You can’t be pregnant or breast feeding
- If you have these health conditions: within 6 months of cancer treatment, blood thinning condition, unstable hormone condition, diabetic consultation and or any condition that prevent you from healing, you can not be a candidate for Permanent Makeup Service.
- Reservation fee is $50 to secure the appointment.
- 48 hours cancellation policy. Cancellation/no show within 48 hours will forfeit the deposit fee. If you cancel before 48 hours, the deposit fee will go toward your future appointment as credit. Once the deposit is made, the deposit will not be refunded in cash.
- Initial appointment and touch up fee vary depend on the artist. Contact us for more info.
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Appointment Reservation Form