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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0542033
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COMPLIANCE INFO
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Last modified
3/8/2024 12:25:30 PM
Creation date
3/22/2021 9:48:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0542033
PE
4120
FACILITY_ID
FA0024127
FACILITY_NAME
LUMIERE SPA (CARRANZA, GEORGINA)
STREET_NUMBER
15
Direction
W
STREET_NAME
OAK
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
15 W OAK ST
P_LOCATION
02
QC Status
Approved
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EHD - Public
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UUt_dUJC CCJUII ULMIII IJ a UIIICIcIII IIIUIVIUUUL UIU_ — i1iui—u-1 _rill — .....I........... .. <br />i'nformaticn you provided could also help in determining whether consultation with your <br />doctor prior to the treatment is necessary or not. <br />If you suffer from a disease/condition that is not mentioned in the table, please inform us on <br />that and indicate what it is about: <br />The information you provided is confidential and it will be treated that way. It will not be <br />disclosed to a third party. <br />1 <br />I consent to photography, filming, recording, and/or digital imaging of the treatment to be <br />performed and usage of the photos for the advertasing purpose. <br />YES NO <br />DISCLAIM RESPONSIBILITY <br />With this agreement, the Artist shall be exempt from all subsequent claims, demands, com- <br />pensation of damages, actions and causes of action arising from the provided service. <br />EXPLANATION: <br />The client is informed in detail by the Artist on the specific risks which may arise from the <br />microblading treatment. <br />The following risks are particularly explained to me as a client- <br />s Regardless of the staff's expertise and all safety precautions, an injury may occur <br />during the treatment. Despite using the latest and best pigments, an allergic reaction is <br />possible, but rare. The client is aware of that and bears responsibility. <br />m During and after the treatment, a temporary swelling, redness and/or itching may <br />
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