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SR0081536
Environmental Health - Public
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4100 – Safe Body Art
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SR0081536
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Entry Properties
Last modified
10/8/2024 12:33:16 PM
Creation date
10/8/2024 12:27:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
SR0081536
PE
4103
FACILITY_NAME
SOLA SALON STUDIOS/PINK LUXX MAKE-UP STUDIO
STREET_NUMBER
37
Direction
W
STREET_NAME
YOKUTS
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10220077
ENTERED_DATE
12/17/2019 12:00:00 AM
SITE_LOCATION
37 W YOKUTS AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
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EHD - Public
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9 <br /> I agree that my technician is limited to the cost of the procedure performed unless it <br /> is proven that the technician was negligent in the performance of her duties. In the event <br /> of disputes that cannot be amicably resolved, the technician and client agree to binding <br /> arbitration to resolve disputes. <br /> I have read and understand the contents of each paragraph above. I have received <br /> no unrealistic warranties or guarantees with respect to the benefits to be realized from, or <br /> consequences of, the procedure(s). <br /> I acknowledge by signing this consent form, I have been given full opportunity to ask <br /> any and all questions about permanent makeup procedure(s) and process(es) from my <br /> technician. <br /> Client: Date: <br /> (First visit signature) (First visit date) <br /> Client: Date: <br /> (Second Visit Signature) (Second visit date) <br /> I personally reviewed the above information with my client, or the client's representative. <br /> Permanent Makeup Technician Date: <br /> (First Visit Signature) (First visit Date) <br /> Permanent Makeup Technician Date: <br /> Second Visit Signature) (Second visit date) <br />
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