is a non-acid, high salt based, fruit seed extract removal product. Lemon seed extract = fading and exfoliation, Orange seed extract = fading and exfoliation, Aloe Vera = skin conditioning, Sterile water.

Great alternative to Laser or used in combination in treatment plan. Unfortunately laser does not penetrate into certain wavelengths to pull out certain colors. Brown is made up of a mix of colors. Saline pulls all colors so you’re not left with green and yellow brows that laser could leave you with.

REMOVAL post care instructions

aftercare

EMERGENCY MICROBLADING/ PMU/TATTOO REMOVAL

If you got your procedure done within the last 48 hours please contact our emergency line by text: (904) 351-8244

If it’s been longer than 48 hours from your initial session, you will need to wait at least 5 weeks before a removal/lightening session can be done. More than one session will be needed in most cases and you must wait a minimum of 8 weeks in between each session.

REMOVAL PACKET

Cancelation policy as noted on booking system: Booking fees/deposits are non refundable. A rescheduling fee will apply if you cancel or reschedule within 3 days of your appointment. Multiple reschedules or cancelations will result in paying in full for future service before appointment request is approved. Cancelations or no shows the day of will result in full cost of services missed. Cristal Walker Beauty has the right to refuse service to anyone.

book appointment

contact

Your Health Intake and Treatment notes are held in the strictest confidence.

service intake/consent form

Name *

First Name

Last Name

Phone *

(###)

###

####

Email *

Birthday

YYYY

Social Media handle

instagram @cristalwalkerbeauty

How did you hear about our services? *

Select Removal type *

Emergency= The tattooed area was done within 48 hours of the request Emergency Removal Session. Removal = Your tattooed area is at least 4 weeks healed

Emergency Removal

Post 4 week Removal

Date of tattoo your inquiring to remove *

Please list date of when you got tattooed/microbladed. For EMERGENCY REMOVAL, please also include what time your tattoo was done at.

Does your job require you to work outdoors? *

Which of the following best describes your complexion? *

I Very Fair: Always burns easily, cannot tan

II Fair: Usually burns, sometimes tans

III Medium: Sometimes burns, always tans

IV Olive: Never burns, always tans

V Brown: Never burns, always tans

VI Black: Never burns, always tans

Have you used the Prescription Oral Acne Medication ACCUTANE or any other brand of Prescription Oral ISOTRETINOIN in the past 12 months? *

yes

not sure

Please Check any of the following that you have had in the past 21 days: *

Botox

Cosmetic Surgery

Chemical peel

Filler Injections

Laser treatments

Radio Frequency or Ultrasound tightening

N/A

Do you have any skin conditions, skin diseases, skin lesions, immune disorders, active infections, blood clots, bleeding problems, diabetes, lupus, current fever blisters/ cold sores, or any other conditions that would limit your eligibility for treatment? If yes, Please explain:

If you are under the age of 18 parental consent must be provided and you must be accompanied by your legal guardian.

Any allergies I should know about?

Describe the tattoo to be lightened? *

Where is the tattoo located? *

The nature and method of the proposed pigment (tattoo) lightening procedure has been explained to me including risks or possibility of complications during or following its performance. I understand there may be a certain amount of discomfort or pain associated with the procedure and that the other adverse side effects may include: minor and temporary bleeding, bruising, redness or other discoloration and swelling. Fever blisters may occur on the lips following lip procedures in individuals prone to this problem. Secondary infection in the area of the procedure may occur, however if properly cared for, this is rare. *

please initial

I understand that several treatments may be needed in order to attempt to achieve my desired results. However, I have not received any guarantees to the quality of the outcome of the process. *

please initial

I understand there are medical options available for pigment (tattoo) removal. I have decided to decline those methods. *

please initial

I understand that the unwanted pigment may not be successfully lightened to the point that it can no longer be seen. Scarring as hyper-pigmentation or hypo-pigmentation, or other damage to the skin may occur during this process and may be permanent. This is rare but it can happen. I will not hold my technician, Cristal Walker and/or the distributor/manufacturer of tattoo removal products used in this attempted pigment (tattoo) lightening or removal liable for any damages that may occur to my person. *

please initial

There will be no refunds if the desired lightening result is not achieved. *

please initial

For skin types V and VI; I understand that I am at a higher risk for hyper-pigmentation and hypo- pigmentation than other skin types. I agree to the risk involved.

V: Brown, moderately pigmented skin VI:Black skin please initial

I understand that lightening tattoo pigment is difficult, if even possible. As a result I will not hold my technician or Cristal Walker responsible for any resultant failure to lighten the unwanted pigment. *

please initial

I agree to submit to before and after photographs, and give my permission to use such photographs for publication and/or teaching purposes. *

please initial

I agree to follow all aftercare instructions provided by me by my technician. *

please initial

I have been fully informed of the natures, risks, possible complications and consequences as listed above. I further understand that my technician is not a medical doctor. *

please initial

I have disclosed all that has been asked of me to the best of my ability and I understand all information listed above. I have had all my questions answered, and agree to all conditions and provisions of this document as evidenced by signature below. I accept the risks for having this procedure done therefore release my technician and Cristal Walker from any and all liability. *

please initial

Thank you!