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Singh, Sandip [EHD] <br />From: Singh, Sandip [EHD] <br />Sent: Tuesday, May 10, 2022 1:41 PM <br />To: Mariana Castillo <br />Subject: Consent Form - Medical Questionnaire - IPCP <br />Hi Mariana, <br />I have reviewed the documents you have submitted. Please correct the following: <br />Eve Liner <br />Consent Form <br />-Add a statement regarding permanent nature of procedure. <br />✓- Notice that inks are not FDA approved and health consequences are unknown. <br />Medical Questionnaire <br />/ -The question regarding herpes should state "history of herpes infection at the procedure site." You may state it <br />differently but it does have to mention "at the procedure site." <br />Microbladin�/ Ombre Brows <br />Consent Form <br />- Description of what the client should expect following the procedure. <br />i- Add <br />a statement regarding permanent nature of procedure, <br />Notice that inks are not FDA approved and health consequences are unknown. <br />Medical Questionnaire: <br />i= Add history of herpes infection at the procedure site (see above). <br />/- Add history of cardiac valve disease. It states heart condition, but it's not the same thing. <br />Lip Blush <br />Consent Form <br />/ -Add a statement regarding permanent nature of procedure. <br />i - Notice that inks are not FDA approved and health consequences are unknown. <br />Medical Questionnaire <br />,i -Add history of herpes infection at the procedure site (see above). <br />Infection Prevention and Control Plan <br />- pg 2 A6: You mentioned anything covered in blood with be disposed in a red biohazardous bag. If you decide to use <br />biohazardous bags then you will have to be in a contract with a company that specializes in biohazardous waste to <br />dispose of the biohazardous bags. Bloody tissues, items, etc... can be disposed with regular garbage. <br />- pg 4 G3: You stated the marking pens go into the sharps waste container. Only sharps waste belongs in the sharps <br />waste container. <br />- pg 4 H: San Joaquin County Hazardous Waste Facility is stated as the sharps waste hauler/ mail back system you plan <br />on utilizing, but the facility is not an approved sharps waste hauler or mail back system. Sharps waste must be disposed <br />by using a licensed hauler or a mail back system. <br />Please update the forms and resubmit. <br />Let me know if you have any questions. <br />Best Regards, <br />