COMPLIANCE INFO_TAYLOR MULROONEY

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PEASE READ AND CHECK BOXES WHEN YOU ARE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING I confirm the following: ❑ I am the person on the legal ID presented as proof that I am at least 18 years of age. ❑ I am not under the influence of alcohol or ❑ I understand t tattooing is permanent and that if I choose to have it removed, it may be expensive and leave scars. ❑ I understand there is a possibility of an allergic reaction to the inks and pigments commonly used in tattooing. ❑ All questions about the body art procedure have been answered to my satisfaction, and I have been given written aftercare instructions for the tattoo I am about to receive. ❑ I understand that tattoo inks,dyes,and pigments have not been approved by the federal Food and Drug Administration and that the health consequences of using these products are unknown. ❑ I understand there is a possibility of getting an infection,and I have been advised of the signs and symptoms of infection that indicate a need to seek medical attention. ❑ I agree to follow all instructions concerning the care of my tattoo,and that any touch-ups needed due to my own negligence will be done at my own expense. ❑ I understand that there is a chance I might feel lightheaded, dizzy during or after being tattooed. ❑ I agree to immediately notify the practitioner in the event I feel lightheaded,dizzy and/or faint before, during or after the procedure. I, have been fully informed of the risks of tattooing including but not limited to infection, scarring,difficulties in detecting melanoma, and allergic reactions to tattoo pigment,latex gloves, and antibiotics. Having been informed of the potential risks associated with getting a tattoo,I still wish to proceed with tattoo application and I assume any and all risks that may arise from tattooing. Signed Date Res 22 Copyright®2016 BA TG