HEALTH

Submit Health Declaration

Health Declaration

Pre Booking Information Page

DECLARATION OF GOOD HEALTH FORM

I hereby submit this form to indicate that I have PASSED a COVID-19 HEALTH SCREENING with Permetika's Medical Director, Dr. Victoria Zavala. Today, my body temperature is lower than 98.6°F/ 37.5°C and I agree to check my temperature before leaving home. If temperature rises, I understand that I must contact Permetika on the CONTACT US button on this page in order to reschedule my appointment. There will be no charge to reset your appointment once, without a doctor's note.

Are you experiencing any flu-like symptoms?

Yes

Do you have any artificial limbs, joints or a pacemaker? Have you ever had MRSA, Staph, or Shingles? If so, please inform us by selecting yes below and contact your doctor for advice regarding any cosmetic prodedures.

Yes

I confirm that the information given in this form is true.

Entering name constitutes legal and binding signature:

Date

Thanks for submitting!

INFO LINKS

Come Experience the Magic!

Submit Health Declaration

3 ON-LINE CLIENT FORMS to submit prior to appt.

HEALTH DECLARATION FORMS

PLANNING YOUR PROCEDURE

CHECK OUT THESE QUICK LINKS TO LEARN MORE ABOUT HOW TO PLAN FOR AND TAKE CARE OF YOUR NEW PROCEDURE!

?

TRUST THE PERMETIKA APPROACH

As you plan for your procedure, it's important to know that we Many permanent makeup artists are trained to apply a little extra color in anticipation of color loss that happens throughout the healing process. ​

As you plan for your procedure, it's important to know that we Many permanent makeup artists are trained to apply a little extra color in anticipation of color loss that happens throughout the healing process.