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POSSIBLE RISKS, HAZARDS OR COMPLICATIONS FOR TATTOOS <br /> Pain: There %vill be some discomfort or pain given the nature of the procedure. Numbing <br /> gel may be used if ciient desires. However, anesthetics work better an scme, people <br /> than others. <br /> Infect on: Infection is very unusual. The areas treated must be kept clean an only freshly <br /> cleaned hands shou d touch the areas. See "After Care" sheet for instructions on care. <br /> Uneven Pigmentation: This can result frorn poor, healing, infections, bleacling or many <br /> other causes. Your fDilcw up appointment will likely correct any un-3ven appearance. <br /> * LE:xcestive Swelling or Bruising, Some people bruise and sw 11' mor® fhar ntruer-, 1--- <br /> packs may heLn and the bruising and swelling -ar,,.nea!,s wil. 4. j-.%.- <br /> 0 , picallydis i-h 1 A;w­, c.nmcn <br /> don't b <br /> IJ:r uise o <br /> I r swell at all <br /> * Anesthesia- Fast acting anesthetics are used to numb the area to be tattooed. Liclocaine, <br /> I I- <br /> Pinlocralne, Benzocaine, Tetracaine, and Epinephrine in a cream or gel form are typically <br /> used. f you are allergic to any of these please inform 11s, nokAi. <br /> * MRI- Recause nigm,--rts, used in normanent r-SM-t*,C proced...es con-tain inert oxi <br /> I L I d e S, C-1 <br /> luow-!,=_�lel rriaplet may IL-e required if you !need to be scanned by an r 11RI machline. You <br /> must inform yo-jr technician of any tattoos r permanent cosmetics. <br /> * COVID 1Q_ VaI:ci-ie: If you got your Covid vaccine within 2 weeks prior to you r <br /> appointment, please reschedule as, there is a high probability that vou will get an <br /> infection after the procedure. <br /> * Allergic Recac-.io-i: there is a small possibility of an allergic reaction to color pigments <br /> especially red inks. Just because you have had prior red tattoos does not mean you are <br /> not su.3-Cleptitt,le to an allergic reartion- niffprpnt hrnnrl rpri inks rnn --ap ocp Ai4prpn+ <br /> reactions. You may take a patch test to determine this at least 2 weeks orior. <br /> Please initial for patch test to: Waive or Take <br /> Name: Signature: Date: <br />