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Job Aids Template For Word 97 (Jatw97) - Rhode Island: What You Should Know

Admin. Code USPS 221.08(1). I further release, discharge,  in favor of Inkstheticare Inc and Inkstheticare Inc employees, affiliates, partners, employees, contractors etc. any and all claims and/or actions of any sort arising from the tattoo treatment undertaken or failure to manage the patient's skin with proper  Health and Safety. I further release any and all damages, liabilities, costs, and expenses that Inkstheticare Inc has incurred, or that could be incurred from the treatment or failure of the patient's skin with proper care, or for any other related medical or medical related claims that could be made. Furthermore, I hereby agree or waive, under penalty of perjury, and I represent that the above statements are true, and will not sue Inkstheticare Inc or any of its operators or affiliates, including  consultants, chiropractors, pain management centers, physician staff, conventional tattoo practitioners, any medical staff and/or surgical crew or associates of Inkstheticare Inc in connection with any and all claims or actions  made against Inkstheticare Inc. (including my legal right to file, and/or receive a lawsuit) arising from any and all claims made through the use of Inkstheticare Inc. procedures. I will not allow the tattoo or the application of Inkstheticare Inc. tattoo treatment to cause injury of any kind to anyone. Furthermore, I will not allow any of my own pain or discomfort or the pain of anyone associated with me. #3204, Signed, Notarized, or Certified: Sign your #3204, Informed Consent to Tattoo Procedure with a physical signature on the bottom and/or on a separate piece of paper. The form is to be delivered to Inkstheticare Inc by Mail, courier, fax, E-Mail, or by any other means as agreed.  #3204 Signed, Notarized, or Certified: Print your #3204, Informed Consent to Tattoo Procedure on a piece of paper that is not less than 5" by 5" and does not contain any information other than the form.

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