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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LODI
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806
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4100 – Safe Body Art
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PR0541656
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COMPLIANCE INFO
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Entry Properties
Last modified
6/20/2024 11:32:48 AM
Creation date
7/3/2020 10:13:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541656
PE
4120
FACILITY_ID
FA0023874
FACILITY_NAME
FLAWLOUS (DEGENSTEIN, PAULA KELI)
STREET_NUMBER
806
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
806 W LODI AVE
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0541656_806 W LODI_.tif
Tags
EHD - Public
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Consent and Re ease Agreement for Microblading <br /> AKA 3D Eyebrow Embroidery <br /> This form is designed to give information needed to make an informed choice of <br /> whether or not to undergo a "Microblading/3D Eyebrow Embroidery Semi- <br /> Permanent" application. If you have questions, please don't hesitate to ask. <br /> Although Microblading/31) Eyebrow Embroidery is affective in most cases, no <br /> guarantee can be made that a specific client will benefit from the procedure. <br /> Microblading/31) Eyebrow Embroidery is the process of inserting pigment into <br /> the dermal layer of the skin and is a form of tattooing. <br /> All instruments that enter the skin or come in contact with body fluids are sealed <br /> and sterilized before use and disposed of after use. Cross contamination <br /> guidelines are stickily adhered to. <br /> Generally, the results are excellent. However, a perfect result is not a realistic <br /> expectation. It is usual to expect a touch-up after the healing is completed. <br /> Initially the color will appear much more vibrant or darker compared to the end <br /> result. Usually within 5-7 days the color will fade 40-50%, soften and look more <br /> natural. The pigment is semi-permanent and will fade over time and will likely <br /> need to be touched-up within 6 months to 2 years. <br /> Photography Release Consent <br /> We would like your permission to use these photos for advertising. Your consent <br /> is necessary regarding this. Please circle and indicate with your signature if you <br /> would like your photos used or not used in advertising, <br /> YES, feel free to use them NO, please do not use them <br /> I have read , understand and agree to the above instructions . <br /> Print Name Signature Date <br /> Special requests, concerns or remarks for technician: <br />
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