Laserfiche WebLink
ThIN <br /> BEAUTY <br /> Any tendency to bleed excessively from minor cuts? <br /> Do you have Epilepsy/Seizures of any kind? <br /> Do you have an autoimmune disorder? <br /> Do you currently have or had cancer?If yes, please explain <br /> Do you have HIV? <br /> Do you have Herpes infection at the procedure site? <br /> Do you have a history of allergic reaction to latex or antibiotics? <br /> history of hemophilia or other bleeding disorders? <br /> history of cardiac valve disease? <br /> other risk factors for bloodborne pathogens? <br /> I understand that the inks used are not FDA approved and health consequences are unknown. <br /> Please indicate any medical conditions: <br /> Please include any medications taking: <br /> Doctors name and number: <br /> Client Signature: Date: <br /> Please contact the artist as soon as possible if you have any medical conditions listed on this <br /> form to prepare and take the necessary precautions at least a week prior to your appointment. <br /> Some health conditions may require doctor's clearance. Thank you. <br />