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A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means,which can be distiguring <br /> and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed. <br /> (PLEASE INITIAL) <br /> I release the right to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or <br /> electronic form. (For assurance, if you do not initial this provision, please inform the Tattoo Studio NOT to take any pictures of you <br /> and your completed tattoo). (PLEASE INITIAL) <br /> I agree that the Tattoo Studio has a NO REFUND policy on tattoos,and/or retail sales and I will not ask for a refund for any reason <br /> whatsoever. (PLEASE INITIAL) <br /> I acknowledge that I have been given adequate opportunity to read and understand this document that it was not presented to me <br /> at the last minute and grasp that I am signing a legal contract waiving certain rights to recover damages against the Tattoo Studio. <br /> (PLEASE INITIAL) <br /> Provide a short description of the tattoo and placement location. (ex:flowers/script on left wrist) <br /> CLIENT INTAKE AND MEDICAL HISTORY <br /> Full Name <br /> First Name Last Name <br /> E-mail Address Contact Number <br /> ex: mynameerexample.com (000) 000-0000 <br /> exampleoexample.com <br /> Address <br /> https://for m.jotform.com/2 31451878214154 5/12/25, 2:10 AM <br /> Page 3 of 9 <br />