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This history has been reviewed&the technician and my questiorl&have been satisfactorily <br /> answered. I have also revie aWhd received a copy of the after sheet and I understand the <br /> and I agree to follow them. <br /> Signature: Date <br /> Befgre and After Photo Consen <br /> By signing below, I give authorization to Eern3ananLftaift to use my before and after photos in <br /> teaching and/or advertising. <br /> Signature Date _® 1 <br /> colorShane and <br /> By signing below, I give my authorization that I approve/reviewed The shape and color discussed <br /> with my browartist prior to the permanent tattoo process. <br /> Signature Date <br /> TeOnician <br /> Pigment info Lot# Fitz# Anesthetics <br /> Machine Needle lot# EXP# <br /> Notes <br /> Date Pigment info anesthetic <br /> Machine Needle lot# EXP# <br /> Notes <br /> Fee with1 touch-up <br />