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Tattoo Consent Form Continued I ACKNOWLEDGE THAT OBTAINING TATTOOS INCLUDING PERMANENT MAKE-UP IS MY CHOICE ALONE. THE APPLICATION OF TATTOOS AND PERMANENT MAKE-UP WILL RESULT IN A PERMANENT CHANGE TO MY APPEARANCE,AND THAT NEEDLES AND INKS WILL GO INTO MY SKIN.I UNDERSTAND THAT AFTER THE PROCEDURE THE ACTUAL COLOR OF THE PIGMENT MAY BE MODIFIED SLIGHTLY,DUE TO THE TONE AND COLOR OF MY SKIN.NO REPRESENTATIONS HAVE BEEN MADE TO ME AS TO THE ABILITY TO LATER RESTORE THE SKIN INVOLVED IN PERMANENT MAKE-UP TO THE ORIGINAL CONDITION,AND IT IS VERY COSTLY TO REMOVE. I UNDERSTAND THAT VARIATIONS IN COLOR AND DESIGN MAY EXIST BETWEEN THE TATTOO ART I HAVE SELECTED AND THE ACTUAL TATTOO WHEN IT IS APPLIED TO MY BODY.I ALSO UNDERTAND THAT OVER TIME,THE COLORS AND THE CLARITY OF MY TATTOO WILL FADE DUE TO UNPROTECTED EXPOSURE TO THE SUN AND THE NATURALLY OCCURRING DISPERSION OF PIGMENT UNDER THE SKIN AND THAT 1 WILL NEED TO MAINTAIN THE COLOR WITH FUTURE APPLICATIONS. 1 UNDERSTAND THAT SUN, TANNING BEDS, POOLS,SOME SKIN CARE PRODUCTS AND MEDICATIONS CAN AFFECT MY TATTOO. I UNDERSTAND THAT A TATTOO IS A PERMANENT CHANGE TO MY APPEARANCE AND CAN ONLY BE REMOVED BY LASER OR SURGICAL MEANS, WHICH CAN BE DISFIGURING AND/OR COSTLY AND WHICH IN ALL LIKELIHOOD WILL NOT RESULT IN THE RESTORATION OF MY SKIN TO ITS EXACT APPEARANCE BEFORE BEING TATTOOED. 1 UNDERSTAND I WILL HAVE PERMANENT MAKE-UP,ALSO KNOWN AS COSMETIC TATTOO,APPLIED USING APPROPRIATE INSTRUMENTS AND STERILIZATION TECHNIQUES.I UNDERSTAND THAT THE PERMANENT MAKE-UP SITE USUALLY TAKES 2 WEEKS OR LONGER TO HEAL. I UNDERSTAND THIS IS A TATTOO PROCESS AND THEREFORE NOT AN EXACT SCIENCE,BUT AN ART.I REQUEST THE PERMANENT MAKE-UP PROCEDURE AND ACCEPT THE PERMANENCE OF THE PROCEDURE AS WELL AS THE POSSIBLE COMPLICATIONS AND CONSEQUENCES OF THE SAID PROCEDURE.I UNDERSTAND THAT WHILE THIS IS SOMETIMES REFERRED TO AS SEMI-PERMANENT IN NATURE,DUE TO EACH INDIVIDUAL'S REACTION TO PIGMENT, THE LENGTH OF TIME PIGMENT IS PRESENT CANNOT BE GUARANTEED.IN SOME CASES,PIGMENT WILL BE PERMANENT. 1 ACKNOWLEDGE INFECTION IS ALWAYS POSSIBLE AS A RESULT OF TATTOO OR PERMANENT MAKE-UP APPLICATION.1 HAVE RECEIVED PRE-AND POST-PROCEDURE INSTRUCTIONS AND I UNDERSTAND THEM AND WILL STRICTLY ADHERE TO SUCH INSTRUCTIONS.I UNDERSTAND THAT MY FAILURE TO DO SO MAY JEOPARDIZE MY CHANCES FOR A SUCCESSFUL PROCEDURE.I AGREE THAT IT IS MY RESPONSIBILITY TO SEEK MEDICAL CARE AND CONTACT MY TECHNICIAN IF THERE ARE ANY SIGNS AND SYMPTOMS OF INFECTION,INCLUDING,BUT NOT LIMITED TO REDNESS,SWELLING, TENDERNESS OF THE PROCEDURE SITE,RED STREAKS GOING FROM THE PROCEDURE SITE TOWARDS THE HEART, ELEVATED BODY TEMPERATURE,OR PURULENT DRAINAGE FROM THE PROCEDURE SITE. I UNDERSTAND THAT THE TAKING OF BEFORE AND AFTER PHOTOGRAPHS OF THE SAID PROCEDURE ARE A CONDITION OF SUCH PROCEDURE.1 RELEASE ALL RIGHTS TO ANY PHOTOGRAPHS TAKEN OF ME AND THE PERMANENT MAKEUP OR TATTOO AND GIVE CONSENT IN ADVANCE TO THIS PERMANENT MAKE-UP STUDIO TO USE IMAGES OF MY TATTOO(S)FOR MARKETING AND, OR PUBLISHING PURPOSES IN VARIOUS MEDIA SUCH AS THE INTERNET,MAGAZINE,PRINTED,AND OR TELEVISION ETC. 1 UNDERSTAND THAT IF I HAVE ANY SKIN TREATMENTS,LASER HAIR REMOVAL,PLASTIC SURGERY OR OTHER SKIN ALTERING PROCEDURES,IT MAY RESULT IN ADVERSE CHANGES TO MY PERMANENT COSMETICS.I ACKNOWLEDGE SOME OF THESE POTENTIAL ADVERSE CHANGES MAY NOT BE CORRECTABLE. Page 2 of 4