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Artistic Binge PR0547582 <br /> 1537 Second St. Escalon, CA 95320 <br /> March 9, 2026 <br /> Photo 17: Client consent form missing all the information on the back page, including signature of client acknowledgement. <br /> '.no <br /> o ha aPvir in <br /> you <br /> loadF <br /> ^ ` r IT th <br /> Thinner, H,—pn Altergto reaction to Allergic raeGlon to <br /> Heart `e er Hblotios yPsoris+ai= <br /> ® How roion 11regnan, =gem <br /> „o d 1 me has rF ❑o you haves it baet"v5 OF SIGNING THIS'DOCUMFNT "'��'"' <br /> %oe�se anyy eration of receiving a tattoo from c""'..r.r. <br /> Do You ha a am not ge to mowing: at Artistic Binge Studio. <br /> procedure�_I tlo not have a his <br /> of her es infection at the proposed procedure sde,diabetes,anergtc <br /> e <br /> Have you id do or to latex or antibiotics,hemophilia or other bleeding disorders,or cardiac valve disease- C <br /> Abe F pies it beat have a history of medications use and am not currently using medtration,including being <br /> r o dare' ho �AII antibiotics prior to dental or surgical procedures. <br /> u t°c scd dy been Questions about the body art procedure have been answered to my satisfaction,and t have <br /> tars u e t° given wdttanonsfarthetton t to _ <br /> er^„a°d nvg1en C The tattoo descraibed q aftercare <br /> on the client oonsent form isI am correctlydrawn tom Pec+urations. <br /> f ,I understand that tattgoing is permanent and that if I choose to have h removed,i may be <br /> the°used a `S e�peani a and leave scars. <br /> M7c*ob,a`e i am not under the hflueocel oOf akcohorl or d rugs p and that am voluntarily B ycare of an' <br /> submitting to be tadooed <br /> d <br /> ,osL or J r without duress or co y <br /> ercion, <br /> _I understand the <br /> is a possibility of an allergic reaction to the inks and pigments wmmony used <br /> Zf in tattoglhg. <br /> �I underslantl that all tattoo inks are not FDA a roved and health consequences are unknown <br /> ,l understand;here i5 a possibility of getting anPnfection and 1 have been advised of the signs and <br /> I don 4 symptoms of infection that indicate a need to seek medical attention-and that any touch ups needed <br /> °5 sr'L _I agree to follow all instruausctions concerning the Cara of my tattoo, P\e a<,�,' <br /> t Into <br /> (cn�ct with ccm- + becl unders and that negligence <br /> a hill be edl done <br /> at feel lightheaded,dizzy t my Own expense andj qr faint before,during.or <br /> into co after procedure. - <br /> L i, have been fuliy informed of the nsk of tattooing 9`u. <br /> including but not limited to risk factors for bloodborne pathogen exposure,irrfectinn and other medical <br /> complications,allergic reactions to metal,latex gloves and antibiotics.4iavm9 been infomted of the <br /> roceduretraVS,etd potential risks associated with receiving a tattoo and I still wish to proceed wdh the procedure.1 <br /> d in p r tops,ttnwi4g1! assume all risk thaf may arise from the tattoo procedure. <br /> WuatvitY 1,110 <br /> O r any n+�°t 5kin{rlited L On completion of your tattoo,it is typical to experience sit ht swelling,redness itching and discomfort. <br /> od", nd ste You notice small amounts of excess ink along with blood and fluid leaking These symptoms typlcally <br /> ct wit cyaged.aautootave t., subside after 3 days.Please see attached aftercare procedure form for more details on cafe and <br /> ', nV Steam signs to contact your artist and seeking medical care. <br /> Signed' fate <br /> it <br /> A in <br /> lk <br /> .r! y <br /> • • • <br /> Alexander Cruz, REHS 17 <br />