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4100 – Safe Body Art
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PR0541621
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COMPLIANCE INFO
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Last modified
3/21/2024 2:38:16 PM
Creation date
4/12/2023 3:50:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541621
PE
4120
FACILITY_ID
FA0023856
FACILITY_NAME
VERSAILLES SALON (GREEN-FRESE, ERICA)
STREET_NUMBER
1010
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
1010 CENTRAL AVE
P_LOCATION
03
QC Status
Approved
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EHD - Public
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Versailles Salon And Spa <br /> 1010 Central Ave* Traa,CA 95376® Salon(209)836-1505 Cell(209)275-9133 <br /> CLIENT COPY <br /> FOR MICROBLADING EYEBROW PROCEDURES <br /> For 14 days following.application of permanent cosmetics: <br /> * Apply A&D ointment sparingly five times a day for five days following the procedure,using a clean <br /> cotton swab;not your fingertips. Use A&D ointment until healed. <br /> * Do not rub or pick at the epithelial crust;allow it to flake off on its own. There should be absolutely no <br /> scrubbing,no cleansing creams or chemicals. Do not expose treated area to full pressure of the water in <br /> the shower. <br /> * Do not soak treated area in bath,swimming pool or hot tub. Do not swim in fresh,salt or chlorinated <br /> pool water. <br /> * Do not expose the treated area to the sun. <br /> * Use a total sun block after the procedure area has healed to prevent future fading of pigment color. <br /> * If you are a blood donor you cannot give blood for 1 year following your procedure (per American Red <br /> Cross). <br /> * Use sterile bandages and dressings when necessary. <br /> I understand that at the first sign of an infection,adverse reaction or allergic reaction to the procedure,I must <br /> notify Versailles Salon&Day Spa,Health care practitioner,and the California Department of Health,Drugs <br /> and Medical Devices Division. <br /> Failure to follow post-treatment instructions may cause loss of pigment,discoloration or infection. <br /> Remember,colors appear brighter and more sharply defined immediately following the procedure. As the <br /> healing progresses,color will soften. A touch-up procedure may or may not be necessary. Final results cannot <br /> be determined until healing is complete. Touch-up procedures must be made between 6-8 weeks following <br /> the procedure. An additional fee of will apply for touch-ups after 8 weeks following the procedure. If <br /> necessary,an appointment for a touch-up can be made. <br /> IF YOU HAVE ANY QUESTIONS PLEASE FEEL FREE TO CALL. <br /> Enjoy your permanent cosmetics! <br /> C:\Users\Versailles 2\Downloads\2017 REVISED Consent Form TEMPLATE.do"Rev:12/5,/2016 Page 2 of 8 <br />
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