My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SR0085220
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
L
>
LODI
>
1012
>
4100 – Safe Body Art
>
SR0085220
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/11/2023 3:51:51 PM
Creation date
8/11/2023 3:48:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
SR0085220
PE
4103
FACILITY_NAME
CACTUS FLOWER TATTOO STUDIO
STREET_NUMBER
1012
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03311033
ENTERED_DATE
5/2/2022 12:00:00 AM
SITE_LOCATION
1012 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
26
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
THIS DOCUMENT IS TWO- PAGES. PLEASE INITIAL IN THE BOXES PROVIDED AFTER <br />READING TO SHOW THAT YOU UNDERSTAND EACH PROVISION, FEEL FREE TO ASK ANY <br />QUESTIONS REGARDING THIS WAIVER. <br />In consideration of receiving a tattoo from Cactus Flower Tattoo Studio including its artists, associates, <br />apprentices, agents, or any employees (hereinafter referred to as the "Tattoo Studio" I agree to the <br />following: <br />- I, .(Print Name) have been fully informed of <br />the inherent risks associated with getting a tattoo. Therefore, I fully understand that these risks, known <br />and unknown, can lead to injury including but not limited to: infection, scarring, difficulties in the <br />detection of melanoma and allergic reactions to tattoo pigment, latex gloves and/or soap. Having been <br />informed of the potential risks associated with getting a tattoo I wish to proceed with the tattoo <br />procedure and application and freely accept and expressly assume any and all risks that may arise from <br />tattooing. <br />- I WAIVE AND RELEASE to the fullest extent permitted by law any person of the Tattoo <br />Studio from all liability whatsoever, including but not limited to, any and all claims or causes of action <br />that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any <br />direct and/or consequential damages, which result or arise from the procedure and application of my <br />tattoo, whether caused by the negligence or fault of either the Tattoo Studio, or otherwise. <br />-The Tattoo Studio has given me the full opportunity to ask any question about the procedure <br />and application of my tattoo and all of my questions, if any, have been answered to my total <br />satisfaction. <br />-The Tattoo Studio has given me instructions on the care of my tattoo while it's healing. I <br />understand and will follow them. I acknowledge that it is possible that the tattoo can become infected, <br />particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed <br />due to my own negligence, l agree that the work will be done at my own expense. <br />- I am not under the influence of alcohol or drugs, and I am voluntarily <br />submitting to be <br />tattooed by the Tattoo Studio without duress or coercion. <br />- I do not suffer from diabetes,. epilepsy, hemophilia, heart conditi <br />on(s), nor do I take blood <br />thinning medicaflon. I do not have any other medical or skin condition that may interfere with the <br />procedure, application or healing of the tattoo. I am not the recipient of an organ or bone marrow <br />transplant or, if I am, I have taken the prescribed preventative regimen of antibiotics that is required by <br />my doctor in advance of any invasive procedure such as tattooing or piercing. I am not pregnant or <br />nursing. I do not have a mental impairment that may affect my judgement in getting the tattoo. <br />-The Tattoo Studio is not responsible for the meaning or spell <br />Page 1 <br />ing of the <br />symbol or text that I <br />have provide <br />to them or chosen from the flash <br />(design) sheets. <br />Page 1 <br />
The URL can be used to link to this page
Your browser does not support the video tag.