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Waiver, Release, and Consent to POcroblading please read and be certain you understand the implications of sign This document is two pages please initial each provision on the lines provided after reading to show that you understand each provision In consideration of receiving permanent Make-up from Shaunessey Fredericksen at The Raven Tattoo&art Gallery(together with its employees,apprentices and agents),I agree to the following. It has been explained to me that the procedure to be used is referred to as Micro-pigmentation El (the process of implanting micro-deposits of pigment into the epidermal layer of the skin).Micro- pigment Implantation is a form of tattooing used for the purpose of permanent cosmetic makeup and skin imperfection camouWe or tattoo removal. I realize the procedure will probably result in permanent and irreversible color change in the skin area treated.However rare,some of possible complications resin from this procedure may include infection, scarring,swelling,bruising,numbness,and post procedure discomfort,allergic reaction to one of the pigments or anesthetic agents(topical or oral) I understand that the practice of this procedure is not ane science.Colors may not mach LJperfectly or appear exactly as expected.Over the months and years following the procedure, softening,fading oro of color of the pigment may occur I understand that there isa possibility of Hyper-pigmentation resulting from a procedure. I have been told that this procedure will most likely involve some pain and discomfort. I understand that no warranty or guarantees have been made to me as to the result of the procedure. I understand that there will be before and after photos taken.Photos will be posted to Instagram and Facebook. I have been given the opportunity to ask questions about the procedure and the risk involved. Full amount is due at the beginning of service.Payment due in cash or card NO REFUNDS NO EXCEPTION. I understand that the description of the procedure is not meant to scare or alarm me.It describes the procedure to be utilized so i may make an informed decision to proceed or refuse the procedure.In consideration of having a service provided by Shaunessey Fredericksen,I fully release and discharge Shaunessey Fredericksen(hereafter referred to as Shaunessey Fredericksen)without limitation,from any and all claims,losses,demands,rights of cause of action,damages or injuries to my person or property,present or future,whether known, anticipated or unanticipated,that may occur from any cause whatsoever,whether based on tort, contract,product liability,or other theory of recovery,as a result of or arising out of any treatment or surgery that may arise from any treatment or procedure by Shaunessey Fredericksen,including,but no limited to,any claims for known,unknown,latent,developed,or undeveloped injuries,anticipated and unanticipated consequences,and known and unknown developments of any such iWuries and claims with respect to the nature,extent,and permanency of any such injuries. Signature: Date: I understand that I might need to a 6 week touch up and all touch are by appointment