Client Name *

First Name

Last Name

Mobile Number *

(###)

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What kind of of Cosmetic Tattoo did you have done? *

Eyebrow Tattoo

Eyeliner Tattoo

Lip Tattoo

Scalp Tattoo

Paramedical

Other

How old is the tattoo? *

> 1 Year

1-2 Years

2-5 Years

5-10 Years

10+ Years

Where were they based? *

Home Based

Professional Salon or Clininc

Other

Did the artist disclose their level of experience or training? *

Yes

No

Did the artist FAIL to conduct any of the following: *

Consultation (including paperwork)

Explain the risks

Asked you to arrange numbing through a pharmacy script?

Asked you about colour selection

Marked out a pre draw for your approval

Made you sign a Treatment Record form

Provided aftercare products and explained post treatment care thoroughly

Demonstrated strict sanitisation and sterilisation standards

Did you experience any side effects? *

Allergic reaction

Infection

Blistering

Scarring (including microblading ridding)

Any other adversity?

How long did your artist spend with you?

I was rushed and felt like I was in a production line (20 mins)

I was given ample time (1-2 hours)

The treatment took too long (3 hours plus)

Was there any issues with cosmetic tattoo overall appearance? *

A-symmetrical

Too Dark

Too Saturated

Too Big

Blotch/Patchy

Wrong Shape

Poorly Crafted

Other

Were you under the impression the tattoo is semi-permanent, meaning: it would completely fade after a few years? *

Yes

No

Were you aware that removal is not always possible and results may be forever? *

Yes

No

Were you aware cosmetic tattoo is not a regulated industry? *

Yes

No

Would you like to see rules, guidelines or stricter regulations in place for the PMU industry? *

Yes

No