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INSTRUMENT LOG <br /> If single-use,pre-packaged,pre-sterilized instruments and needles are used please maintain the following records: <br /> (1) A record of purchase and use of all single-use instruments. <br /> (2) A log of all procedures,including the names of the practitioner and client and the date of the procedure. <br /> (3) Written proof on company or laboratory letterhead showing that the presterilized instruments have undergone a sterilization process.Written proof shall <br /> clearly identify the instruments sterilized by name or item number and shall identify the lot or batch number of the sterilizer run. <br /> Supplier Instrument/Needle Lot/ID# Sterilization Date Expiration Invoice Number <br /> AFTERCARE INSTRUCTIONS <br /> CLIENT NAME: <br /> The following verbal and/or written instructions were communicated to the client: <br /> 1.Information on the care of the procedure site. <br /> 2.Restrictions on physical activities such as bathing,recreational water activities,gardening,or contact with animals,and the duration of the restrictions. <br /> 3.Signs and symptoms of infection including but not limited to redness,swelling,tenderness of the procedure site,red streaks going from the procedure site towards <br /> the heart,elevated body temperature,or purulent drainage from the procedure site. <br /> 4.Instructions to call a physician if any of the addressed signs and symptoms appear or for any other reason related to the Body Art procedure(s). <br /> S.If physician care is required by the client related to the Body Art procedure(s),the client is to notify the Body Art facility and practitioner of the problem and the <br /> resolution by a physician or clinic.This information shall be placed in the client's file. <br /> COMMENTS: <br /> To the best of my knowledge this information is correct: <br /> Practitioner Signature: Date: <br /> I have received aftercare instructions: <br /> Client Signature: Date: <br /> SW P-152 8/15/17 <br /> www.m icrobladingriches.corn <br />