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Client record — Permanent Cosmetics and Tattooing Informed Consent <br />Last Name <br />Address <br />Street <br />First Name <br />Date <br />State <br />Date of Birth Location on Body Name of Practitioner <br />COPY OR DESCRIPTION OF PERMANENT COSMETIC OR TATTOO <br />1 accept this design or procedure. Client Signature <br />Permanent Cosmetics and Tattooing Page 1 of 3 <br />