top of page

MICROBLADING/MICROSHADING DISCLOSURE & RELEASE FORM

Have you received chemotherapy or radiation in the past year?
Have you ever had a cold sore? If yes, contact your physician for a preventative prescription capsule to prevent a cold sore.
Have you ever had an allergic reaction to any of the following? Select all that apply.
Are you currently taking medication that thins the blood?

Thanks for submitting!

©2020 by Kent County Paramedical Aesthetics & Spa | 390 Toll Gate Road, Suite 200A, Warwick RI 02886 | 401-203-6131

bottom of page