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I have been told that the markings are perma7t�nt and there is a risk of infection following the procedure® <br /> I have been told that there is a chance I may experience a corneal abrasion from an eyeliner procedure. <br /> _I have been told that there is a chance of allergic reaction to pigment and that my body may reject the pigment. <br /> I have been given an opportunity to ask questions about the procedure and the procedure to be used and the risks and hazards involved and I believe <br /> that I have sufficient information to give this informed consent. <br /> I have agreed that should I have a complaint of any kind whatsoever,I shall immediately notify <br /> I understand that if(I have an infection,adverse reaction or allergic reaction to the procedure.I must notify salon. <br /> I have received a copy of the Pre/Post Procedure Instructions.The instructions have been fully explained to me and I have read them or they have <br /> been read to me.I understand the instructions. <br /> I certify this form has been fully explained to me and I have read it or it has been read to me.I understand the contents. <br /> Client Signature Date <br /> Technician Signature Date <br /> NAME: <br /> ADDRESS: <br /> CITY: STATE: <br /> PHONE: CELL: <br /> EMAIL: <br /> SPECIAL NOTES: <br />