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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR2500864
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COMPLIANCE INFO
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Entry Properties
Last modified
3/9/2026 9:17:55 AM
Creation date
2/9/2026 11:42:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR2500864
PE
4120 - Single Use
FACILITY_ID
FA0005243
FACILITY_NAME
THE CHAMELEON METHOD (QUINTANA, HARLEIGH)
STREET_NUMBER
37
Direction
W
STREET_NAME
YOKUTS
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
37 5 W YOKUTS AVE STOCKTON 95207
Suite #
5
Tags
EHD - Public
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I, the undersigned client, hereby acknowledge that I have voluntarily chosen to undergo skin camouflage <br /> tattooing procedures with The Chameleon Method. I have been fully informed about the nature of the <br /> procedures,including their purposes,potential risks,and expected outcomes. <br /> I understand that tattooing involves the permanent placement of ink into the skin to create skin camouflage <br /> design or color brightening image. The procedures may be performed in one or more sessions, and the duration <br /> and results may vary. I am aware that, as with any cosmetic procedure, there are potential risks and side effects <br /> associated with tattooing.These may include but are not limited to: <br /> 1. Pain or Discomfort:The tattooing process may cause discomfort or pain during and after the procedure. <br /> 2. Infection: There is a risk of infection at the tattoo site, especially if aftercare instructions are not followed <br /> diligently. <br /> 3. Allergic Reactions:In rare cases,individuals may experience an allergic reaction to tattoo ink. <br /> 4. Scarring:While uncommon,scarring may occur as a result of the tattooing process. <br /> 5. Color Fading:Over time,tattoo colors may fade due to factors such as sun exposure and skin aging. <br /> I have disclosed any pre-existing medical conditions or concerns, including allergies,previous tattoo procedures, <br /> or medications I am currently taking. I understand that it is important to follow the pre and post-care <br /> instructions provided by The Chameleon Method to maximize the effectiveness of the tattoo and minimize <br /> potential risks. <br /> I have been informed about alternative cosmetic procedures and have chosen tattooing based on my preferences <br /> and understanding of the procedures. <br /> I also understand that any inks used are NOT FDA approved meaning consequences of use are unknown and or <br /> may vary from person to person. <br /> I hereby give my informed consent to Harleigh Quintana Owner/Artist at The Chameleon Method to perform <br /> the tattooing procedures as described.I understand the potential blood borne pathogens risks and benefits of the <br /> procedures and agree to follow all instructions provided by the tattoo artist. <br /> I release The Chameleon Method , its employees, and representatives from any claims or liability arising out of <br /> the tattooing procedures,except those resulting from negligence or intentional misconduct. <br /> ................................................................................................................................................. ............_......................................................................_.................................................................... <br /> Client's Signature Date <br /> THE CHAMELEON METHOD <br />
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