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Client Informed Consent for Tattooing <br /> The Loft <br /> Last Name First Name Date <br /> Address <br /> sired Apt. City Mate ZIP <br /> Date of Birth Location n Body of Tattoo Name of Practitioner <br /> Copy or Description of Tattoo <br /> a <br /> ccept this design,Chant Signature­---- <br /> ID <br /> i oature­_ --� � <br /> ID ID <br /> Place Photo ID here <br /> Sterile instruments used in the procedure: <br /> Instrument Lot number Purchase date <br />