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Please Review the following Medical Health Form prior to scheduling your Microblading Procedure, and be prepared to list all of the medications you have taken in the last 6 months.  Review the questions below and provide honest, up-to date responses.

It is your responsibility to complete and sign a physical copy of the Medical Health Form
provided the day of your Microblading procedure.  Based on your responses you may not be eligible to receive a Microblading procedure.

Medical Health Form
Have you taken any Aspirin or Ibuprofen in the last 2 days?
Have you had chemotherapy or radiation in the last year?
Allergies: Are you allergic to any of the following?
Have you had a dental injection to numb your mouth?
Are you presenly pregnant or breast feeding?
MRI scan scheduled in the next 3 months?
Do you give blood?
Prior to dental procedures do you receive antibiotic therapy?
Have you had Botox or other injectables?
Laser or IPL scheduled in the next 3 months?
Are you currently under the care of a doctor or hospital specialist?
Medical Conditions:
Have you had a Micropigmentaton procedure before?
For re-touch procedure only (please check)

Please Review the After Care Instructions

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