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Consent Form Requirements <br /> Health and Safety Code(H&SC) <br /> In Out <br /> Client is at least 18 years of age- 119302 (a) <br /> Parents/Guardian signature of minor receiving body piercing— 119302 (b) <br /> Signature of client agreeing they have read and completed the consent form— 119303 (a) <br /> Description of procedure— 119303 (a) 1 <br /> Description of what the client should expect following the procedure- 199303 (a)2 <br /> Statement regarding permanent nature of procedure— 119303 (a) 3 <br /> Notice that inks are not FDA approved and health consequences are unknown— 119303 (a)4 <br /> Post-procedure Instructions <br /> H&SC 119303 (a) 5 <br /> In Out <br /> Information of proper care for procedure site— 119303 (a) (5) (A) <br /> Restrictions on physical activities— 119303 (a) (5) (B) <br /> Signs and symptoms of infection— 119303 (a)(5) (C) <br /> Indications when to seek medical care— 119303 (a) (5)(D) <br /> Medical Questionnaire <br /> H&SC 119303 (b) <br /> In Out <br /> Client status regarding pregnancy- 119303 (b) 1 <br /> History of herpes infection at the procedure site— 119303 (b) 2 <br /> History of diabetes— 119303 (b) 2 <br /> History of allergic reactions to latex— 119303 (b)2 <br /> History of allergic reactions to antibiotics— 119303 (b)2 <br /> History of hemophilia or other bleeding disorders— 119303 (b)2 <br /> History of cardiac valve disease 119303 (b)2 <br /> Current medications— 119303 (b)3 <br /> Requirements for antibiotics prior to surgery or dental procedures— 119303 (b)3 <br /> Other risk factors for blood borne pathogens— 119303 (b)4 <br /> Form B <br />