Client Questionnaire Client Questionnaire Please complete the questionnaire below before your appointment. Your responses help ensure that your service can be performed safely and appropriately and allow Kayana Beauty to prepare for your appointment. Client Questionnaire About You Name * Name First Name First Name Last Name Last Name Phone * Email * Preferred Pronouns * She/HerHe/HimThey/ThemOtherPrefer not to disclose Have you received services at Kayana Beauty before? * Yes No Health & Safety Are you under 18 years old? * Yes No Are you currently pregnant or nursing? * Yes No Are you prone to or have a history of keloid scarring? * Yes No Are you currently taking any medications, including antibiotics or immunosuppressants? * Yes No Please list the medications you are currently taking. Have you used Accutane within the last 12 months? * Yes No Have you ever tested positive for HIV or Hepatitis? * Yes No Do you have any bleeding disorders, such as hemophilia? * Yes No Are you diabetic? * Yes No Please contact Kayana Beauty before proceeding with your appointment. Diabetes may affect healing and your suitability for certain services. Do you have an autoimmune condition that may affect your ability to heal normally? * Yes No Please describe the condition. Are you allergic to any anesthetics and/or antibiotics? * Yes No Please list the anesthetic(s) and/or antibiotic(s) you are allergic to. Are you currently taking any blood thinners? * Yes No Please list the blood thinner(s) or medication(s) you are currently taking. Do you have any of the following conditions? Select all that apply. * Epilepsy Fainting or diziness Herpes Hepatitis B (HBV) Tuberculosis (TB) Eczema or psoriasis Other skin condition Asthma None of the above OtherOther Skin & Healing What is your skin type? * Normal Dry Oily Combination Acne Prone Not Sure Have you used any retinoids (such as retinol), AHAs/BHAs, Proactive, or other products containing active ingredients within the last four weeks? * Yes No Please list the product(s) you are currently using and where you apply them. Have you had any recent sun exposure, tanning, or sunburn in the area to be treated? * Yes No Please describe when the sun exposure/tanning occurred and whether the area is currently sunburned or significantly darker than usual. Is the skin in or around the are you would like treated currently irritated, inflamed, broken, or experiencing a rash? * Yes No Please describe what you're experiencing and where. Have you had an recent procedures, injections, or treatments performed on or near the area you would like treated? * Yes No Please tell us what treatment you had and when. Do you have a history of delayed healing or unusually prolonged redness, swelling, or irritation after skin procedures or injuries? * Yes No Please describe your experience. Appointment & Service Information What service are you completing this questionnaire for? * Custom Brow Tattoo Corrective Brow Tattoo Brow Tattoo Refresh/Maintenance Freckle Tattoo Beauty Marks Eyebrow Tattoo Removal Lip Tattoo Removal Body Tattoo Removal Emergency Tattoo Removal ISR - Inkless Stretch Mark Revision Scar Revision Stretch Mark Camouflage Scar Camouflage Returning Client Check-In Since your last appointment at Kayana Beauty, has anything changed regarding your health, medications, allergies, pregnancy/nursing status, or skin/healing that you think we should know about? * Yes No Please tell us what has changed. * Have you experienced any unusual reaction, prolonged healing, or other concern following any previous service at Kayana Beauty? * Yes No Please describe the reaction, healing concern, or other concern. * Brow History Have you ever had your eyebrows tattooed, microbladed, or otherwise cosmetically enhanced? * Yes No Previous Brow Work Approximately how many brow tattoo/microblading sessions have you had? * 12345+Not sure When was your most recent brow tattoo/microblading session? * Who was your previous artist/establishment? Is there currently visible pigment remaining in your brows? * Yes No I'm not sure Existing Brow Pigment How would you describe the current visibility of the remaining pigment? * Still quite visible Moderately visible Faded only a little 50% faded 75% faded Faint shadow I'm not sure Are there any noticeable pigment discolorations? * Gray Blue Red Pink Purple Orange Yellow None that I know of Is there any scarring or textural change in the brow area from previous tattooing or removal? * Yes No I'm not sure Please describe the scarring or textural changes, including where they are located and whether the area is raised, indented, or otherwise uneven. * Have you had any removal procedures performed on your brows? * Glycolic Saline Laser None OtherOther Corrective Brow Tattoo What type of brow enhancement did you previously have? * Microblading Powder/Ombre Brows Combination Brows Nano Brows Traditional Brow Tattoo I'm not sure OtherOther Please tell us what type of brow enhancement you previously had. * What would you like to achieve with Corrective Brow Tattoo? * Shape Improvement Color Adjustment Hair Stroke and/or Shading Refinement Saturation Correction What is the current shape of your existing brows? * I like the existing shape and want to maintain it I'd like to make minor shape adjustments I'd like significant shape changes I'm not sure Are you looking to keep any of your existing brow pigment in the final result? * Yes No I'm not sure Does the existing brow tattoo extend beyond the natural brow shape you would like to have? * Yes No I'm not sure Are there areas where the existing brow pigment is noticeably uneven, patchy, or inconsistent? * Yes No I'm not sure What would you most like to change about your existing brows? * Shape Color Symmetry Thickness Tail shape or placement Arch shape or placement Pigment saturation Uneven or patchy areas I'm not sure OtherOther Is there anything specific about your previous brow tattoo that you are hoping we can correct or improve? * How would you describe the result of any previous brow correction or removal treatments? * The pigment faded as expected The pigment faded unevenly The pigment changed color The pigment became darker I experienced scarring or textural changes I experienced an unexpected reaction I have not had any previous correction or removal treatments I'm not sure Is there anything else about your previous brow work, correction, or removal history that you would like us to know? Custom Brow Tattoo What are you hoping to achieve with your new brows? * A fuller, more defined appearance A more symmetrical appearance A more structured/defined shape A natural-looking enhancement Reduced need for daily brow makeup To restore brows with sparse or missing hair OtherOther How would you describe your natural brow hair density? * Full/dense Moderate Sparse Very sparse Little to no brow hair I'm not sure How do you typically wear your brows? * I usually leave them natural I lightly fill them in I fill them in regularly I draw/define my brows heavily It varies What best describes the look you'd like for your new brows? * Very natural and subtle Natural but more defined Soft and polished More structured and defined Bold and defined I'm not sure Do you currently have any areas of missing or sparse brow hair that you would like to have visually restored? * Yes No I'm not sure Have you ever experienced significant hair loss or thinning of your eyebrows? * Yes No I'm not sure Do you regularly remove or alter your natural brow hair? * Waxing Threading Tweezing Shaving/Trimming None OtherOther When was the last time you had your brows waxed, threaded, tweezed, or otherwise professionally shaped? * Within the last week 1-2 weeks ago 3-4 weeks ago More than 4 weeks ago I don't regularly have them shaped How often do you currently use brow makeup or products? * Never Occasionally A few times a week Most days Every day What is most important to you when choosing your brow tattoo result? * A natural appearance Long-lasting results Minimal daily maintenance Defined/structured brows Fuller-looking brows Symmetry Soft, subtle enhancement I'm not sure OtherOther Is there anything specific about your natural brows that you'd like us to consider when designing your new brows? Brow Tattoo Refresh/Maintenance When was your most recent brow tattoo session? * Was your most recent brow tattoo Session performed by Kayana Beauty? * Yes No How many times have you had your brows tattooed previously? * 1 time 2 times 3 times 4 or more times I'm not sure What would you like to accomplish with today's Brow Tattoo Refresh/Maintenance? * Refresh existing color Refresh existing shape Add definition Add density Make minor adjustments to the shape Make minor adjustments to the color Address fading or uneven pigment OtherOther How would you describe the current condition of your brow pigment? * Still quite visible Moderately faded Significantly faded Very faint Uneven/patchy No longer visible I'm not sure Are you currently happy with the overall shape of your brows? * Yes Mostly, but I'd like minor adjustments No What changes would you like to make to the shape of your brows? * Are you currently happy with the color of your brows? * Yes Mostly, but I'd like minor adjustments No What would you like to change about the color of your brows? * Since your last brow tattoo session, have you had any brow tattooing, correction, or removal performed by another artist or establishment? * Yes No Please tell us what was done, when it was done, and who performed the service. * Have you experienced any changes, concerns, or unusual reactions with your brows since your last session? * Yes No Please describe the changes, concerns, or reaction you experienced. * Freckle Tattoo Have you ever had freckles tattooed or otherwise cosmetically enhanced before? * Yes No Do you currently have natural freckles? * Yes No A few Not sure How would you describe the appearance of your natural freckles? * Very faint Light Moderate Dark/prominent They vary in color and intensity I don't have natural freckles Where would you like your freckles to be placed? * Across the nose Across the cheeks Nose and cheeks Forehead Chin Upper lip area OtherOther Where else would you like your freckles placed? * How would you like your freckles to look? * Very subtle and natural Soft and natural-looking Noticeable but still natural-looking More defined and noticeable I'm not sure What overall effect are you hoping to achieve with your freckle tattoo? * Enhance my existing freckles Create the appearance of freckles where I don't naturally have them Add more freckles to areas where I already have some Create a sun-kissed appearance Add a youthful/playful appearance Even out the appearance of my freckles I'm not sure OtherOther Previous Freckle Tattoo Approximately how many freckle tattoo sessions have you had? * 12345+Not sure When was your most recent freckle tattoo session? * Who was your previous artist/establishment? How would you describe the current condition of your previous freckle tattoo? * Still quite visible Moderately visible Faded Very faded Faint/shadow-like No longer visible I'm not sure Have you had any removal procedures performed on your previous freckle tattoo? * Glycolic Saline Laser None OtherOther Are there any noticeable pigment discolorations from your previous freckle tattoo? * Gray Blue Red Pink Purple Orange Yellow None that I know of Is there any scarring or textural change in the areas where you previously had freckle tattooing? * Yes No I'm not sure Is there anything specific about your previous freckle tattoo that you would like us to correct or improve? Freckle Tattoo Preferences How would you describe the amount of freckles you'd like to have? * Very few and widely spaced Lightly scattered Moderately scattered More concentrated I'm not sure Would you like your freckle tattoo to look more symmetrical or more naturally random? * More symmetrical and evenly distributed Naturally random and varied A balance of both I'm not sure Are there any specific freckles or areas of your face that you would like us to preserve or incorporate into your design? Is there anything about your desired freckle tattoo result that you are particularly concerned about or want us to avoid? Is there anything else you'd like us to know about your desired freckle tattoo? Beauty Marks How many beauty marks would you like to have tattooed? * 1 2 3 4 5 Where would you like your beauty mark(s) placed? * Forehead Temple Cheek Under eye Nose Above the lip Below the lip Chin OtherOther Do you have any existing moles, beauty marks, freckles, or other skin markings in the area where you would like your beauty marks placed? * Yes No Please describe the existing mark(s) and where they are located. * Are you looking to recreate an existing beauty mark or create a new one? * Recreate an existing beauty mark Create a new beauty mark Both Do you have a clear photo showing the beauty mark you would like recreated? * Yes No Please upload a clear photo of the existing beauty mark you'd like recreated. Drop a file here or click to upload Choose File Maximum file size: 516MB Eyebrow Tattoo Removal Have you had eyebrow tattoo removal before? * Yes No Have you previously received eyebrow tattoo removal at Kayana Beauty? * Yes No What would you like the tattoo removal to achieve? * Suitable for Corrective Brow Tattoo Complete Removal If your goal is complete removal, are you planning to have new brow tattooing or corrective work after the pigment has been sufficiently removed? * Yes No I'm not sure Which of the following removal procedures have you previously had performed on your eyebrows? * Glycolic Saline Laser OtherOther How many eyebrow tattoo removal sessions have you had previously? * 1 2 3 4 or more I'm not sure When was your most recent eyebrow tattoo removal session? * What type of removal procedure was performed during your most recent session? * Glycolic Saline Laser I'm not sure OtherOther What is the current condition of the pigment? * Still quite visible Faded only a little 50% faded 75% faded Faint shadow Not visible at all I'm not sure Are there any pigment discolorations currently visible in your eyebrows? * Gray Blue Red Pink Purple Yellow None OtherOther Have you experienced any unusual changes or reactions in the treated area following your previous removal session? * Yes No Please describe the changes or reactions you experienced. * Is there currently any visible scarring or textural change in the treated area? * Yes No I'm not sure Please describe the scarring or textural changes you currently see. * Has anything else been applied to or performed on your eyebrows since your most recent tattoo removal session? * Yes No Please tell us what was applied or performed and when. * What is the current condition of your eyebrow skin? * Normal Dry or flaky Red or irritated Sensitive or tender Bumpy or textured I'm not sure OtherOther Are you currently experiencing any irritation, inflammation, itching, or otherwise discomfort in the treated area? * Yes No Please describe what you are experiencing. * Is there anything else about your eyebrows or previous removal treatment(s) that you would like us to know about? Lip Tattoo Removal Have you had lip tattoo removal before? * Yes No Have you previously received lip tattoo removal from Kayana Beauty? * Yes No What would you like the tattoo removal to achieve? * Suitable for Corrective Lip Tattoo Complete Removal If your goal is complete removal, are you planning to have new lip tattooing after the pigment has been sufficiently removed? * Yes No I'm not sure Which of the following removal procedures have you previously had performed on your lips? * Glycolic Saline Laser OtherOther How many lip tattoo removal sessions have you had previously? * 1 2 3 4 or more I'm not sure When was your most recent lip tattoo removal session? * What type of removal procedure was performed during your most recent session? * Glycolic Saline Laser I'm not sure OtherOther What is the current condition of the lip tattoo pigment? * Still quite visible Faded only a little bit 50% faded 75% faded Faint shadow Not visible at all I'm not sure Are there any pigment discolorations currently visible in the treated area? * Gray Blue Red Pink Purple Yellow Orange Brown None OtherOther Have you experienced any unusual changes or reactions in the treated area following your previous removal session? * Yes No Please describe the changes or reaction you experienced. * Is there currently any visible scarring or textural change in the treated area? * Yes No Please describe the scarring or textural changes you currently see. * Has anything else been applied to or performed on your lips since your most recent tattoo removal session? * Yes No Please tell us what was applied or performed and when. * What is the current condition of your lips? * Normal Dry or flaky Red or irritated Sensitive or tender Bumpy or textured Cracked or peeling I'm not sure OtherOther Are you currently experiencing any irritation, inflammation, itching, burning, tenderness, or other discomfort in the treated area? * Yes No Please describe what you are experiencing. * Is there anything else about your lips or previous removal treatment(s) that you would like us to know? Body Tattoo Removal Have you had this tattoo removed before? * Yes No Was the previous removal of this tattoo performed at Kayana Beauty? * Yes No Where is this tattoo located? * ArmForearmUpper armWristHandFingerShoulderChestBreastBackRibcageAbdomenHipButtocksThighKneeCalfAnkleFootNeckOther Where is this tattoo located? Approximately how large is this tattoo? * Smaller than 1"x1" 1"x1" to 2"x2" Larger than 2"x2" I'm not sure What colors are in this tattoo? * Black Gray Brown Red Orange Yellow Green Blue Purple Pink White I'm not sure OtherOther What would you like the tattoo removal to achieve? * Suitable for a new tattoo or cover-up Complete Removal If your goal is complete removal, are you planning to get a new tattoo or cover-up after the pigment has been sufficiently removed? * Yes No I'm not sure Which removal procedures have you previously had performed on this tattoo? Glycolic Saline Laser OtherOther How many removal sessions have you previously had on this tattoo? * 1 2 3 4 or more I'm not sure When was your most recent removal session for this tattoo? * What type of removal procedure was performed during your most recent session on this tattoo? * Glycolic Saline Laser I'm not sure OtherOther What is the current condition of the tattoo pigment * Still quite visible Faded only a little 50% faded 75% faded Faint shadow Not visible at all I'm not sure Are there any pigment discolorations currently visible in this tattoo? * Gray Blue Red Pink Purple Yellow Orange Brown None OtherOther Have you experienced any unusual changes or reactions in the treated area following your previous removal session? * Yes No Please describe the changes or reaction you experienced. * Is there currently any visible scarring or textural changes in the treated area? * Yes No I'm not sure Please describe the scarring or textural changes you currently see. * Has anything else been applied to or performed on this tattoo since your most recent removal session? * Yes No Please tell us what was applied or performed and when. * What is the current condition of the skin on/around this tattoo? * Normal Dry or flaky Red or irritated Sensitive or tender Bumpy or textured I'm not sure OtherOther Are you currently experiencing any irritation, inflammation, itching, burning, tenderness, or other discomfort in the treated area? * Yes No Please describe what you are experiencing. * Is there anything else about this tattoo or your previous removal treatment(s) that you would like us to know? Emergency Tattoo Removal What type of tattoo requires emergency removal? * Cosmetic Tattoo Body Tattoo When was the tattoo performed? * Was the tattoo performed at Kayana Beauty? * Yes No What type of cosmetic tattoo was performed? * Eyebrows Lips Freckles Beauty Mark OtherOther What prompted you to seek emergency removal? * Where is the tattoo located? * ArmForearmUpper armWristHandFingerShoulderChestBreastBackRibcageAbdomenHipButtocksThighKneeCalfAnkleFootNeckOther Where is the tattoo located? Approximately how large is the tattoo? * Smaller than 1"x1" 1"x1" to 2"x2" Larger than 2"x2" I'm not sure What prompted you to seek emergency removal? * Has anything been applied to or performed on the tattoo since it was performed? * Yes No Please tell us what was applied or performed and when. * What is the current condition of the skin on the treated area? * Normal Red or irritated Swollen Sensitive or tender Bleeding or oozing Dry or flaky I'm not sure OtherOther Are you currently experiencing any pain, burning, itching, or other discomfort on the treated area? * Yes No Please describe what you are experiencing. * Is there anything else about the tattoo or the area that you would like us to know before your appointment? Inkless Stretch Mark Revision Have you had Inkless Stretch Mark Revision performed on these stretch marks before? Yes No Have you previously received ISR (Inkless Stretch Mark Revision) at Kayana Beauty for these stretch marks? * Yes No What would you like ISR to achieve? * Improve the appearance of my stretch marks Reduce the appearance of discoloration Improve the appearance of texture Improve both color and texture I'm not sure Where are the stretch marks you'd like treated? * Stomach/Abdomen Inner Thighs Outer Thighs Inner and Outer Thighs Hips/Flank Buttocks/Glutes Full Lower Body Upper Arms Breasts Lower Back Knees Calves OtherOther How long have you had these stretch marks? * Less than 6 months 6 months to 1 year 1 to 2 years 2 to 5 years More than 5 years I'm not sure What do your stretch marks currently look like? * Light or white Pink Red Purple Brown or darker than my natural skin tone Indented or sunken Raised I'm not sure OtherOther Have you previously had any other treatments performed on these stretch marks? Yes No What treatment(s) did you have, and when? Have you experienced any unusual changes or reactions in these stretch marks following your previous ISR or other treatment(s)? Yes No Please describe the changes or reaction you experienced. * Is there currently any visible scarring or textural change in the treated area? * Yes No I'm not sure Please describe the scarring or textural changes you currently see. * Has anything else been applied to or performed on these stretch marks since your most recent ISR session? * Yes No Please tell us what was applied or performed and when. * What is the current condition of the skin on the area being treted? * Normal Dry or flaky Red or irritated Sensitive or tender Bumpy or textured I'm not sure OtherOther Are you currently experiencing any irritation, inflammation, itching, burning, tenderness, or other discomfort on the area being treated? * Yes No Please describe what you are experiencing. * Is there anything else about your stretch marks or previous treatment(s) that you would like us to know? Scar Revision Have you had revision performed on this scar before? * Yes No Have you previously received Scar Revision at Kayana Beauty for this scar? * Yes No What would you like Scar Revision to achieve? * Improve the appearance of the scar Improve the texture of the scar Reduce the appearance of discoloration Improve both color and texture I'm not sure Where is the scar located? * FaceEyebrowLipsNeckChestBreastAbdomenBackShoulderArmForearmHandWristFingerHip/FlankButtocksThighKneeCalfAnkleFootOther Where is the scar located? What caused the scar? * Surgery Injury/Accident Burn C-Section Cosmetic Procedure Piercing I'm not sure OtherOther How long have you had this scar? * Less than 6 months 6 months to 1 year 1 to 2 years 2 to 5 years More than 5 years I'm not sure What does the scar currently look or feel like? * Lighter than my natural skin tone Darker than my natural skin tone Red or pink Purple Raised Indented or sunken Flat Firmed or hardened Soft Textured or uneven I'm not sure OtherOther Have you previously had any other treatments performed on this scar? * Yes No What treatment(s) did you have and when? * Have you experienced any unusual changes or reactions following previous treatment of this scar? * Yes No Please describe the changes or reaction you experienced. * What is the current condition of the skin on/around the scar? * Normal Dry or flaky Red or irritated Sensitive or tender Bumpy or textured I'm not sure OtherOther Are you currently experiencing any irritation, inflammation, itching, burning, tenderness or other discomfort around the scar? * Yes No Please describe what you are experiencing. * Is there anything else about this scar or previous treatment(s) that you would like us to know? General Consent & Acknowledgement By submitting this questionnaire, I confirm that the information I have provided is complete and accurate to the best of my knowledge. I understand that individual results, healing, pigment retention, and the degree of improvement vary from person to person and cannot be guaranteed. I understand that results may be affected by factors including my skin, health, medications, lifestyle, previous treatments or procedures, and adherence to pre-care and aftercare instructions. I agree to follow all pre-care and aftercare instructions provided by Kayana Beauty and understand that additional sessions may be recommended or necessary depending on the service and how my skin responds. * I have read and understand the General Consent & Acknowledgment above and agree to proceed with my requested service. Cosmetic Tattoo Conditions Please review the following Cosmetic Tattoo Conditions before proceeding with your service. These conditions supplement the full Terms & Policies available on the Kayana Beauty website. Custom Brow Tattoo – Design & Implantation (New Set): This service is intended for brows with no existing cosmetic tattoo ink. If you have existing cosmetic tattoo work, you must book a Corrective Brow Tattoo – Rebuild & Redesign (Existing Work) service instead, unless your existing work has been assessed and specifically approved by Kayana Beauty for a Custom Brow Tattoo service. Failure to provide clear photos of existing work when requested may result in forfeiture of the booking fee. Corrective Brow Tattoo – Rebuild & Redesign (Existing Work): Existing brow tattoo work must be assessed and approved by Kayana Beauty before treatment. Results will depend on the existing pigment, its color, saturation, placement, shape, depth, and condition of the skin. Previous work may affect the final result, and complete coverage, removal, or correction of existing pigment cannot be guaranteed. Perfection & Refinement Session – Brow Tattooing: Following an initial brow tattoo session, a 6–10 week Perfection & Refinement Session is required to complete the initial brow tattooing process. This session is not included in the initial service price. If the Perfection & Refinement Session is not completed within the 6–10 week timeframe, the applicable 3–6 month Brow Tattoo Refresh/Maintenance option must be selected. Brow Tattoo Refresh/Maintenance: Brow Tattoo Refresh/Maintenance sessions are intended to maintain the appearance of previously completed brow tattooing. A Refresh/Maintenance session must be completed at least once within a 24-month period. After 24 months, the service is considered a brand new brow tattoo session and will be subject to the applicable initial-session requirements. Nature of Cosmetic Tattooing: Cosmetic tattooing is a tattoo process and an art rather than an exact science. Every effort will be made to create balanced and symmetrical results; however, no face is completely symmetrical and exact symmetry cannot be guaranteed. Color, Shape & Placement: I understand that the color, shape, and placement of my cosmetic tattoo will be discussed and agreed upon during my consultation. I understand that individual facial features, existing pigment, and natural asymmetry may affect the final result. Healing & Final Results: Temporary swelling, redness, tenderness, or sensitivity may occur following treatment and will generally subside as the area heals. Bruising may also occur in some cases. The initial appearance of the tattoo will change during the healing process, and the true color and healed result should be evaluated approximately 6–8 weeks after each procedure. Pigment, Retention & Results: Pigment color, retention, and healed results vary according to individual skin tone, skin type, skin condition, age, and other factors. Medication, skin characteristics such as dry, oily, sun-damaged, thick, or thin skin, pH balance, lifestyle, tanning or sun exposure, exfoliation, skincare routines, and aftercare may affect the healed result. No guarantee can be made regarding exact color, pigment retention, symmetry, or final results. Fading & Longevity: Cosmetic tattooing is considered semi-permanent; visible results may fade over approximately 1–3 years depending on individual factors. Even after visible color has faded, pigment may remain in the skin indefinitely. The appearance of pigment may also change over time due to the natural tone and color of the skin, sun exposure, aging, lifestyle, and other factors. Risks & Complications: Cosmetic tattooing carries known and unknown risks and complications associated with cosmetic procedures, including but not limited to allergic reaction, infection, scarring, inconsistent color, pigment migration or spreading, fanning, fading, and changes in pigment color or appearance. Pigments & FDA Regulation: Non-toxic pigments are used during the procedure. I understand that the FDA does not approve or exercise regulatory authority over the color additives used in pigments for semi-permanent or permanent cosmetics and tattoo inks in the same manner as it regulates drugs or medical devices. I understand that an allergic reaction to pigment is a possible risk and that Kayana Beauty cannot guarantee that an allergic reaction will not occur. Hygiene & Sterility: Kayana Beauty maintains high standards of hygiene and sanitation. Sterile, disposable needles and pigment containers are used for each individual client, procedure, and visit. Animals & Aftercare: For the health and safety of your newly treated area, avoid handling, petting, or coming into close contact with animals immediately following your appointment and during the initial healing period. Animal dander, hair, saliva, and other contaminants may come into contact with the treated area and increase the risk of irritation or infection. Follow the specific aftercare instructions provided by Kayana Beauty regarding when normal contact with animals may resume. Aftercare: I understand that following all pre-care and aftercare instructions provided by Kayana Beauty is an important part of the healing process and may affect pigment retention and the final result. * I have read and understand the above Cosmetic Tattoo Conditions and agree to proceed with my requested service. Tattoo Removal Conditions Please review the following Tattoo Removal Conditions before proceeding with your service. These conditions supplement the full Terms & Policies available on the Kayana Beauty website. Removal Process: Tattoo removal is a process that occurs over multiple sessions as the skin heals and the body gradually clears treated pigment. The number of sessions required varies based on the type, color, depth, density, age, and location of the pigment, as well as skin characteristics, previous treatments, and individual healing response. Complete removal cannot be guaranteed. Previous Removal Treatments: Previous laser, saline, glycolic, or other tattoo removal treatments may affect the skin and the way remaining pigment responds to treatment. Existing scarring, pigment changes, or textural changes may also affect results. Pigment Changes: Pigment may change color during the removal process. Certain colors may be more resistant to removal or may respond differently than others. Changes in pigment color or the appearance of previously hidden colors may occur during treatment. Healing: Temporary redness, swelling, tenderness, sensitivity, dryness, scabbing, blistering, or other temporary skin changes may occur following treatment. Healing varies from person to person and depends on the treatment area, skin characteristics, previous treatments, and individual healing response. Risks & Complications: Tattoo removal carries known and unknown risks and complications, including but not limited to infection, scarring, changes in skin texture, changes in pigmentation, hyperpigmentation, hypopigmentation, prolonged redness or irritation, and incomplete or uneven pigment removal. Existing Skin & Pigment: Existing cosmetic tattooing, body tattooing, previous removal treatments, scarring, skin conditions, and other factors may affect the outcome. Results cannot be guaranteed. Aftercare: I understand that following all pre-care and aftercare instructions provided by Kayana Beauty is essential to proper healing and may affect the outcome of my treatment. Treatment Timing: Additional removal sessions must be spaced appropriately to allow the treated area to heal. Treating the area again before it has adequately healed may increase the risk of complications and may negatively affect results. Emergency Tattoo Removal: Emergency Tattoo Removal is intended for recently performed tattoos where early intervention may be appropriate. Emergency removal does not guarantee complete reversal or removal of the tattoo, and results will vary depending on the tattoo, skin, timing, and individual healing response. Animals & Aftercare: For the health and safety of your newly treated area, avoid handling, petting, or coming into close contact with animals immediately following your appointment and during the initial healing period. Animal dander, hair, saliva, and other contaminants may come into contact with the treated area and increase the risk of irritation or infection. Follow the specific aftercare instructions provided by Kayana Beauty regarding when normal contact with animals may resume. * I have read and understand the above Tattoo Removal Conditions and agree to proceed with my requested service. Revision Conditions Please review the following Revision Conditions before proceeding with your service. These conditions supplement the full Terms & Policies available on the Kayana Beauty website. Nature of Revision Services: ISR (Inkless Stretch Mark Revision) and Scar Revision are corrective and restorative procedures intended to improve the appearance and/or texture of existing stretch marks or scars. Results vary from person to person, and complete removal or complete restoration of the treated area cannot be guaranteed. Individual Results: Results depend on factors including the age, size, depth, color, texture, location, and condition of the stretch marks or scars, as well as individual skin characteristics, healing response, lifestyle, previous treatments, and aftercare. Previous Treatments: Previous treatments or procedures performed on the stretch marks or scars may affect the skin's condition and how it responds to treatment. Existing pigment, scarring, textural changes, or other alterations to the tissue may affect the final result. Healing: Temporary redness, swelling, tenderness, sensitivity, dryness, or other temporary changes may occur following treatment. The treated area will change as it heals, and the final result may take time to develop. Pigment & Color: Where pigment is used as part of the service, color and pigment retention may vary according to individual skin tone, type, condition, age, lifestyle, and healing response. Exact color matching and pigment retention cannot be guaranteed. Risks & Complications: Revision procedures carry known and unknown risks and complications, including but not limited to infection, scarring, changes in skin texture, changes in pigmentation, hyperpigmentation, hypopigmentation, irritation, and an inconsistent or uneven result. Additional Sessions: Multiple sessions may be recommended or necessary depending on the condition of the treated area and how the skin responds. Results cannot be guaranteed after any specific number of sessions. Aftercare: I understand that following all pre-care and aftercare instructions provided by Kayana Beauty is essential to proper healing and may affect the final result. Animals & Aftercare: For the health and safety of your newly treated area, avoid handling, petting, or coming into close contact with animals immediately following your appointment and during the initial healing period. Animal dander, hair, saliva, and other contaminants may come into contact with the treated area and increase the risk of irritation or infection. Follow the specific aftercare instructions provided by Kayana Beauty regarding when normal contact with animals may resume. * I have read and understand the above Revision Conditions and agree to proceed with my requested service. Client Signature & Acknowledgement By signing below, I confirm that I have reviewed and completed this questionnaire truthfully and accurately. I acknowledge that I have read and understand the General Consent & Acknowledgment and, where applicable, the service-specific conditions presented above. I have had the opportunity to ask questions regarding my requested service and voluntarily consent to proceed. Client Signature * signature keyboard Clear Date * Submit If you are human, leave this field blank. Follow @kayanabeauty on Instagram!
