Laserfiche WebLink
D <br />Please list current medications: <br />By signing below, I acknowledge, understand and agree that: <br />El <br />• Technicians at Pretty Obsessed Boutique do not practice medicine, does not accept health insurance, <br />and have made no representation to the contrary <br />• The information provided on this form is accurate and complete to the best of my knowledge, and that <br />Pretty Obsessed Boutique is not responsible for complications or problems arising from any incorrect or <br />omitted information <br />• Pretty Obsessed Boutique has taken extreme precaution to limit any exposure to blood borne <br />pathogens. Although necessary protocols have been performed I am aware of the risk factors involved <br />during and after treatment(s). <br />• Some individuals will have complications related to semi-permanent makeup application. These <br />complications are usually mild and last only a few days. However, extreme complications are always a <br />possibility. I accept these risks and agree to hold Pretty Obsessed and its employees and contractors <br />harmless for same <br />• The technicians at Pretty Obsessed will use the information provided above to assess my suitability for <br />the proposed permanent makeup services. <br />Print Name: <br />Signature: <br />Date: <br />