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KD Kaesthetics Online Patch Test Form

Patch Testing involves placing small amounts of the substance (Ink, Inkless Serum) against the skin and affixing it in place for 48-72 hours. The testing site is then monitored for local reaction. Potential adverse events include rash at the site, infection, or delayed skin reactions.

 

There is a possibility of an allergic reaction to pigments. Pigment contents Consist of: iron oxide, titanium dioxide, isopropyl alcohol, glycerin, ethanol, and distilled water. Inkless Serum Consist of: Jojoba, Camellia Seed, Vitamin E, Neroli essential, Lavender essential and Lemon Oils.

 

A patch test is advisable however it does not ensure a client will not have an allergic reaction.

I CONSENT TO A PATCH TEST

I release, KD Kaesthetics, Keisha Davis, and any and all assistant(s) from any liability if I develop an allergic reaction to the tattoo/permanent makeup pigments during or after tattoo/permanent makeup procedure(s).

I automatically release the technician and assistants from liability if I develop an allergic reaction to the pigment.

Thanks for submitting!

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