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BODY <br /> P E L, E N E S I S <br /> STRETCH MARK/SCAR:.AMOUFLAGE TATTOOING <br /> I understand that tattoo inks/dyes,pigments have not been approved by the Federal Food&Drug Administration <br /> (FDA)and that health consequences of these products is unknown. <br /> F-1 <br /> I understand that some permanent pigment can only be removed with a surgical procedure;effective removal may <br /> leave permanent scarring or disfigurement. <br /> Also under rare circumstances,misplacement of the permanent makeup pigment can occur,requiring excision of <br /> the misplaced permanent makeup pigment.,I will receive after care instructions and will ask questions if I do not <br /> understand them. <br /> Further,I agree to follow ALL instructions concerning care following my procedure. <br /> F1I am aware that I am required to return for a touch up procedure at 8 weeks following my initial procedure. <br /> F] I understand I will be required to pay a fee for annual or subsequent touch ups. <br /> PHOTO RELEASE WAIVER (required) <br /> Please select one <br /> I consent to have photo(s) and/or video of the procedure area before/after taken and shared for use in Body <br /> Regenesis LLC and Body Regenesis academy marketing efforts,including social media,website&print materials <br /> F-1 <br /> I do not consent to have photo(s)and/or video of the procedure area before/after taken and shared for use in Body <br /> Regenesis LLC and Body Regenesis academy marketing efforts,including social media,website&amp;print materials <br /> COSMETIC TATTOOING CONSENT RELEASE(required) <br /> Please check each box to indicate that you have read through it and understand it completely. <br /> I am not under the influence of drugs or alcohol. <br /> I do not have acne,freckles,moles,or sunburn in the area to be tattooed that might be agitated by the tattoo process <br /> (healing excluded). <br /> I acknowledge that I am not pregnant. <br /> I acknowledge that I have truthfully represented to the associates,agents and representatives of Body Regenesis LLC. <br /> that I am over eighteen(18)years of age <br /> I acknowledge it is not reasonably possible for the associates,agents and representatives of Body Regenesis LLC.to <br /> determine whether I might have an allergic reaction to the dyes,pigments,or processes used in my tattoo and I <br /> agree to accept that such risks are possible. <br /> I acknowledge that infection is always possible as a result of obtaining a tattoo particularly in the event that I do not <br /> take proper care of my tattoo,and that I have been advised of the signs and symptoms of infection that indicate a <br /> need to seek medical care. <br /> DI acknowledge receipt of written instructions advising me of proper care of my tattoo and recognize the absolute <br /> necessity of following these written instructions. <br /> 4 <br />