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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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YOKUTS
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4100 – Safe Body Art
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PR0545526
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COMPLIANCE INFO
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Entry Properties
Last modified
3/29/2023 4:06:34 PM
Creation date
7/3/2020 10:14:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0545526
PE
4120
FACILITY_ID
FA0025846
FACILITY_NAME
CHANNDA'S BROW STUDIO (SON, CHANNDA)
STREET_NUMBER
37
Direction
W
STREET_NAME
YOKUTS
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
02
SITE_LOCATION
37 W YOKUTS AVE STE 5
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0545526_37 W YOKUTS_.tif
Tags
EHD - Public
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hold harmless the Technician, all employees, contractors, and the <br /> management of the permanent makeup studio for any and all claims <br /> of negligence, damages, or legal actions arising from or <br /> connected in any way with my permanent makeup procedure. <br /> 4. 1 acknowledge infection is always possible as a <br /> result of permanent makeup application, and I agree to follow all <br /> suggested instructions concerning the care of the permanent <br /> makeup site while it is healing. Possibilities may include: <br /> redness, minor bleeding, swelling, tenderness, allergic reaction, <br /> hypertrophic, keloid formation, cornea abrasion bruising, <br /> inconsistent color and/or spreading or fanning of pigment. <br /> 5. 1 understand the actual color of the pigment may be <br /> modified after the procedure, due to the tone and color of my <br /> skin. <br /> 6. 1 understand that positioning of my procedures can <br /> be affected if I elect to have cosmetic surgery, Botox, Restylane <br /> or Juvederm. <br /> 7 . 1 am aware that if I am to receive an MRI after the <br /> procedure, I must tell the Radiologist that I have iron oxide <br /> permanent cosmetics. <br /> 8 . If I am a lens wearer, I realize that I must keep <br /> my lenses out the day of an eyeliner procedure. <br /> 9. 1 understand that this procedure is permanent in <br /> nature, but will fade over time. This fading can alter the <br /> original color and that this determines that it is time for a <br /> Touch-ups should be done every year to maintain the integrity of <br /> the up color. <br /> 10. 1 give my consent to confer with my physicians for <br /> medical information required for the safety of my procedures. <br /> 11. 1 agree to accompany my technician to the <br /> emergency room in the event they were to be accidentally with my <br /> needle and take a blood test for their safety and disclose all <br /> test results to my technician. <br /> 12 . 1 am aware that if an infection occurs after I <br /> have received permanent cosmetics to see my physician and to <br /> contact my technician in that regard. <br /> 13. If I had permanent cosmetics performed previously <br /> by another technician, I will not hold Channda's Brow Studio, <br /> responsible for future allergic <br /> contraindications. <br /> 14 . 1 understand that the taking of before and after <br /> photographs of the said procedure (s) are for the purpose of <br /> documentation, which may or may not be used for educational or <br /> advertising purposes. <br /> 15. 1 am over the age of 18, and not under the <br /> influence of any drug or alcohol. <br /> 16. 1 have received a copy of my aftercare <br /> instructions to follow for 7-10 days. <br /> 17. 1 am aware that permanent cosmetic inks, dyes, and <br /> pigments have not been approved by the federal Food and Drug <br /> Administration and that the health consequences of using these <br /> products are unknown. <br /> 2 <br />
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