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______ That both Artist and Infusion SMP, LLC have given me the full opportunity to ask any and all questions about the application of my procedure and all of my questions have been answered to my total satisfaction. ______ Artist and Infusion SMP, LLC have given me instructions on the care of my permanent micropigmentation while it’s healing, and I understand them and will follow them. I acknowledge that it is possible that the body art can become infected, particularly if I do not follow the instructions given to me. If any touch -up work to the artwork is needed due to my own negligence, I agree that the work will be done at my own expense. ______ A Micropigmentation procedure is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before having this procedure done. Infusion SMP, LLC will not be responsible for the removal of any micropigmentation procedure. ______ I acknowledge that the inks used are not FDA approved and health consequences are unknown -119303 (a) 4. ______ I understand that photos will be taken of my procedures by Artist. I release all rights to any photographs taken of me and the finished body art and give consent in advance to their reproduction in print or electronic form. (If you do not initial this provision, please advise and remind Artist and Infusion SMP, LLC not to take any pictures of you and your completed micropigmentation.) ______ I acknowledge that I have been given adequate opportunity to read and understand this document and I understand that I am signing a legal contract waiving certain rights to recover against Artist and/or Infusion SMP, LLC. ______ I acknowledge the late policy for appointments made with Artist and/or Infusion SMP, LLC. Arriving more than 15 minutes late for an appointment will incur a $100 fee. Furthermore, I acknowledge the late policy for appointments arriving 30 minutes late or more is automatically rescheduled and will incur a $100 fee. ______Appointments cancelled within 36 hours will incur a $200 fee and will be required to reschedule. ______ I understand that if I do not come with my hair trimmed to a near bald level at any micropigmentation session (where applicable) a haircut will be required for a fee of $50 per haircut, due the day of the appointment. ______ As an option, a topical pain relief solution is available to help reduce sensitivity during treatment at a cost of $200 per session.