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Perfect Day Tattoo PRO546258 521 W Kettleman Ln. Lodi CA, 95242 March 28, 2025 Photo 10: Client consent form missing information filled out on the tattoo description. PERFECT DAB ` TOO C0NSEN [ TO TATTOO PR0(- LDURL Name: �� e TS al 4 L I sppv� /y Asec ,," Iota.....No.: Phone: (7 1' F) AtltlfBes: I (1`�� n •v._.IlJ.ln ap Yeu nave anY elletgles is enY am lI8btJ1les? . 1 V/A ��`1yJ�`O0^`JI �I r C'4�`r'r� Po you have a hrsrory or.»vnirark.n use,orerc cunenrty usln8 medmeHpn fnafpdrog prescrrhea onrrbroucs prcor ra a su.growr er.enter pracetlrneP Please llet: 1//� 1 ynu hove poulls 6.NepAHIs C.or afher rank facrors)blpadbpme paibogens9 l 7//t f aaknowreag�ey..suing rues agreement rhor!bsve>xMrt given the full oppanunlly to ssk any sna/sr�i quaetrons whleh!might Have rboul my quesrrons r,sv,c even ens vetted ro my NII saHolscrron r spec faceuy eaknewrri 9�a✓v obacn onwsea or rr�roars and metiers set fodH helew one t eg.ce ss foxews: �I do not.require antibiotks before surgery or tlenlal pracetlures. IIr'If I have any condition that might aria.the healing of this tattoo,I will advl..my Tattooer e"I am not pregnant,nursing,or under the Imfu—of alcohol or tlrugs. [-K-1 do net have medical or Skin Conditions SUCK a5 W or limited te:acne.scarring(kelold),eczema,psarl-W.freckle.,moles,—Win or herpes in the area W be Iattcoe that may Interfere wine sand tattoo,a I have arty type Of Infection or ra.h anywhere on my body.1 wilt ad—my taneoer. Tj�'#I have any hisory of hamopheka or other pleading dlsorder,diW»Tes or any hoan conditions such as cerdlac v01,e dis�asusa I vrlil let the artist know. r i have advised the tattooer of any allergies to metals,Ise.glove&soaps and mechae ns dek—Adge it Is net reasO.ahlY P.—flat.for Fhe S Tattooer or other empleyaes of this tattoo shop to tletermine Whether I might nave an allergic reacti.n W the pigmems Or proce55.s involved In Atha tattoo and further acknowledge that such.—erlpn is possible.1 agree to accept the risk Inds 6 I,a reaction Is po.slble_ Ivy I acknowledge that infaction is a1Way.POS.ible as a result of obtalttiog a tattoo,pi,ti lerly In the B of that 1 de nottake proper care a1 my tattoo.1 will accept aftemare instructions and I agree W f e oIIOW them while mylahoo is healing_I agree Mat any tellah-uF work neded.due to my Own negligence.will be dons at my awn.-pans-. �reelire that yanations m color and d—gn may exist betyveen any tattoo as selected by me and as ultimately applied to my body I understand that If my skin epior is dark,the Colors will not appear a.bright as they do On fairer skin_ [q- 1 uhderstand that if I ham any skin treatments,laser hair removal,p,aetic surgery or The,skin altering procedures,It may....It in adverse changes to my tattoo. Ly_f acknowledge that a tattoo is a permanent change to my appeal—oe and that no mpresemetiens have peen made 10 me as to the ability to later change or remove my tattoo.To my knowledge.I do not have a physical,metnal or mladicat impairment or disability whtch might affect my wet belrg ea a d-1 or I",,,or result of my decill1r1 to have 1111110 I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone,I consent to the application of the tattoo and to any actlons or conduct of the repres fodeilvea and employees of the tattoo shop reasonably necessary W Parts"this tattoo pracedure. Taffoo Inks,dyes arrd pigments have not been approved by the federal food and drug edminisirafion and the health oonsequences of using these p—d cts ere unknown. Afler the radon p ura you can P—cf minor sore s,.wooing for ort per iod of time roftnived by your tattoo peeltng(like a sunbum does)as j pert offha heat p cess. I Signature: lY, _ pare: � Talton: NEEDLE BATCH.- �d�`-i DATE', TUBE BATCH: -T DATE' Alexander Cruz, EHS 10