Brow Boutique by KN

1. Client Details

Full name

Date of birth

Phone number

Email address

Address

Emergency contact (name & number)

2. Medical History

Please tick anything that applies to you, now or in the past.

Allergies (tick all that apply)

Other allergies (please specify)

Anything else we should know medically?

3. Medications / Substances

4. Previous Brow History

Have you had previous microblading / PMU?

YesNo

If yes, when?

If yes, by whom?

Any laser or saline removal?

Recent brow tinting / waxing / lamination?

Were you dissatisfied with previous work? Why?

5. Skin Assessment

6. Contraindications & Safety

7. Brow Goals & Preferences

Tell us about your brow goals — desired style, thickness, arch shape, colour and anything you dislike about your current brows.

8. Consent & Acknowledgement

Please tick each item to confirm your understanding.

I confirm the procedure has been explained to meI understand results vary by skin type and lifestyleI understand a touch-up is usually requiredI understand the healing processI agree to follow the aftercare instructionsI understand exact symmetry cannot be guaranteedI understand the risks (fading, infection, allergic reaction, uneven retention)

May we use photos of your brows for our portfolio?

Yes, I consentNo, I do not consent

9. Signature

Type your full name below as your digital signature. The practitioner section will be completed in person on the day of your appointment.

Client signature (type full name)

Date

ConsultationForm

Consultation
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