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Alabama Tattoo Laws

ALABAMA DEPARTMETNT OF PUBLIC HEALTH

ADMINISTRATIVE CODE

CHAPTER 420-3-23 BODY ART PRACTICE AND FACILITIES

TABLE OF CONTENTS

420-3-23-.01 General Provisions

420-3-23-.02 Definitions

420-3-23-.03 Body Art Operator Requirements and Professional Standards

420-3-23-.04 Exemptions

420-3-23-.05 Client Information and Site Care Information

420-3-23-.06 Client Health

420-3-23-.07 Records Retention

420-3-23-.08 Preparation and Care of the Body Art Area

420-3-23-.09 Sanitization and Sterilization Procedures

420-3-23-.10 Inks, Dyes, Pigments, Needles, and Equipment

420-3-23-.11 Single-use Items

420-3-23-.12 Physical Facilities

420-3-23-.13 Licenses and Permits

420-3-23-.14 Temporary Establishment License or Operator Permit

420-3-23-.15 Prohibitions

420-3-23-.16 Compliance and Enforcement

420-3-23-.17 Department Personnel Competency Requirement

420-3-23-.18 Repealer

Appendix A Critical Items

Appendix B Consent For Minor

Appendix C Model

Appendix D Site Care Instructions

Appendix E Medical History

Appendix F Body Art Facility Inspection Report

420-3-23-.01 General Provisions.

(1) Purpose – The purpose of these rules is to protect the health of the public by establishing standards for the prevention of disease that may be associated with tattooing, body piercing, and branding. These rules shall be interpreted and applied to protect the public health.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.02 Definitions.

(1) "Biohazard waste" means any liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; sharps; and any wastes containing blood and other potentially infectious materials.

(2) "Body art" means the practice of physical body adornment using invasive procedures and, for the purpose of these rules, is an inclusive term for any procedures utilizing body piercing, tattooing, cosmetic tattooing, branding or scarification. Physicians licensed by the Alabama Licensure Commission and who perform body art procedures as part of patient treatment are exempt from these rules. Nor does this definition include, for the purposes of these rules, piercing of the ear using pre-sterilized single use stud and clasp ear piercing systems.

(3) "Body art facility" or "Tattoo facility" means the geographic location at which an individual does one or more of the following for compensation:

(a) Places an indelible mark upon the body of another individual by the insertion of a pigment in or under the skin.

(b) Places an indelible design upon the body of another individual by production of scars (branding).

(c) Performs body piercing.

(4) "Body piercing" means the perforation of human tissue other than ear for a nonmedical purpose.

(5) "Branding" means a permanent mark made on human tissue by burning with a hot iron or other instrument.

(6) "Clean technique" means the technique used to prevent or reduce the transmission of microorganisms from one person to another or from one place to another. It includes, but is not limited to:

(a) Meticulous handwashing with soap and water;

(b) Maintaining the sterility of supplies;

(c) Using barriers; in particular, clean, disposable, single-use gloves;

(d) Proper cleaning and preparation of the body site area; and

(e) Maintaining a clean and sanitary environment by using a detergent to remove soil and a disinfectant agent to clean up a spill of blood or other potentially infectious materials.

(7) "Cosmetic tattooing" means a tattoo procedure designed primarily to place a permanent color or pigment in or under the skin or mucosa and that is intended to be used in lieu of cosmetic make-up, such as permanent eyeliner or lip color.

(8) "Critical item" means:

(a) a provision of these rules that, if in non-compliance, has the potential for immediate impact on the public health by resulting in infection of either clients or staff of a body art facility, or disease transmission among clients or staff of a body art facility, or

(b) an administrative provision of these rules that is necessary to ascertain the likelihood of infection or disease transmission among clients or staff of a body art facility or to inform the public, and

(c) are referred to in Appendix A of these rules.

(9) "Department" means the State Department of Public Health.

(10) "Disinfectant" means an agent that destroys microorganisms, particularly pathogenic microorganisms.

(a) These can be disinfectants or sanitizers that are registered with the U.S. Environmental Protection Agency (EPA). Household bleach (sodium hypochlorite) with no fragrance or other additives may also be used as a germicide.

(b) Over-the-counter pre-mixed bleach products can be used or a 1:100 dilution of household chlorine bleach (5.25% sodium hypochlorite) can be made fresh daily and dispensed from a spray bottle (500ppm, 1/4 cup per gallon of water or 2 tablespoons per quart of water).

(11) "Disinfection" means a process that eliminates many or all pathogenic microorganisms, with the exception of bacterial spores, on inanimate objects, thereby rendering them safe for use or handling.

(12) "Equipment" means all machinery, including fixtures, containers, vessels, tools, devices, implements, furniture, display and storage areas, sinks and all other apparatus and appurtenances used in connection with the operation of a body art facility.

(13) "Handwashing sink" means a lavatory equipped with hot and cold running water under pressure, through a mixing valve, used solely for washing hands, arms or other portions of the body.

(14) "Hot water" means water which attains and maintains a temperature of at least 100º F.

(15) "Informed consent" means a written consent signed by the client prior to having any body art procedure performed and which provides information and/or counseling on risks and possible complications of the procedure to be performed.

(16) "Instruments used for body art" means hand pieces, needles, needle bars and other instruments that may come in contact with a client's body or possible exposure to bodily fluids during body art procedures.

(17) "Invasive" means entry into the body either by incision or insertion of an instrument into or through the skin or mucosa, or by any other means intended to puncture, break or compromise the skin or mucosa.

(18) "Jewelry" means any personal ornament inserted into a newly pierced area. Jewelry for body piercing use shall be made of surgical implant grade stainless steel; solid 14k or 18k white or yellow gold; niobium, titanium, or platinum; which is free of nicks, scratches, or irregular surfaces; has been properly sterilized prior to use, and has not been previously used. The Department may approve other materials upon request and review.

(19) "License" means the written document issued by the Department for the operation of a tattoo facility. Approval is given in accordance with these rules and is separate from any other licensing requirement of any local laws, rules, or ordinances.

(20) "Minor" means an individual under 18 years of age who is not emancipated. An emancipated minor is or has been married or has by court order otherwise been legally freed from the care, custody, and control of his or her parents.

(21) "Operator" means any person who controls, operates, manages, conducts, or practices body art activities at a body art facility and who is responsible for compliance with these rules, whether actually performing body art activities or not. The term includes technicians or apprentices who work under the operator and perform body art activities.

(22) "Permit" means the written document issued by the Department to an individual denoting that the individual has received training as specified in these rules. The permit is given in accordance with these rules and is separate from any other licensing requirement of these rules for the body art facility or any local laws, rules, or ordinances.

(23) "Person" means an individual, any form of business or social organization or any other non-governmental legal entity including but not limited to a corporation, partnership, limited liability company, association, trust or unincorporated organization.

(24) "Physician" means a person licensed by the Alabama Licensure Commission to practice medicine in all its branches.

(25) "Procedure surface" means any surface of an inanimate object that contacts the client's unclothed body during a body art procedure, skin preparation of the area adjacent to and including the body art procedure or any associated work area which may require sanitizing.

(26) "Sanitize/sanitization procedure" means a process of using a disinfectant to reduce the numbers of microorganisms on cleaned surfaces and equipment to a safe level.

(27) "Shall" means a mandatory requirement.

(28) "Sharps" means any object (sterile or contaminated) that may purposefully or accidentally cut or penetrate the skin or mucosa including, but not limited to, pre-sterilized, single use needles, scalpel blades and razor blades.

(29) "Sharps container" means puncture-resistant, leak-proof container that can be closed for handling, storage, transportation and disposal and is labeled with the International Biohazard Symbol.

(30) "Single-use" means products or items that are intended for one-time, one-person use and are disposed of after use on each client. This includes, but is not limited to, cotton swabs or balls, tissues or paper products, paper or plastic cups, gauze and sanitary coverings, razors, piercing needles, tattoo needles, scalpel blades, stencils, ink cups and protective gloves.

(31) "Site care" means written instructions on caring for the body art and surrounding area given to the client, and specific to the body art procedure(s) rendered.

(32) "Sterilization" means the complete elimination or destruction of all forms of microbial life, including highly resistant bacterial spores and is accomplished by the use, according to manufacturer’s directions, of a properly functioning autoclave or dry heat sterilizer that is manufactured to be used for sterilization.

(33) "Tattoo" means an indelible mark made upon the body of another individual by the insertion of a pigment in or under the skin or an indelible design upon the body of another individual by production of scars other than by branding.

(34) "Tattoo facility" means a facility as defined under "Body art facility" in this rule.

(35) "Tattooing" means any method of placing ink or other pigment into or under the skin or mucosa of another individual by the aid of needles or any other instrument used to puncture the skin, resulting in permanent coloration of the skin or mucosa. This includes all forms of cosmetic tattooing.

(36) "Temporary body art facility" means any place or premise operating at a non-mobile, fixed location where an operator performs body art procedures for no more than 14 days consecutively in conjunction with a single event or celebration.

(37) "Universal precautions" or "Standard precautions" means a set of guidelines and controls established by the Center for Disease Control and Prevention (CDC) for the prevention of transmission of bloodborne pathogens (specifically; the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)).

(a) This method of infection control requires the employer and employee to assume that all human blood and body fluids are potentially infectious.

(b) Precautions include hand washing, gloving, personal protective equipment, injury prevention, and proper handling and disposal of needles, other sharp instruments, and blood and body fluid-contaminated products.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.03 Body Art Operator Requirements And Professional Standards.

(1) Licensed facility required – Except as otherwise allowed in these rules, all body art procedures shall be performed in a body art facility which has a current, valid license issued by the Department.

(2) Consent age -

(a) No person shall perform any body art procedure upon a minor unless the person obtains the prior, written, informed consent of the parent or legal guardian of the minor, as shown in Appendix B, Consent for Minor.

(b) The parent or legal guardian of the minor shall execute the written informed consent required in this rule in the presence of the individual performing the body art procedure on the minor, or in the presence of an employee or agent of that individual.

(c) Nothing in this section is intended to require an operator to perform any body art procedure on a minor with parental or guardian consent.

(3) Clients under the influence - A person shall not perform any body art procedure upon another individual if, in the opinion of the operator, the other individual, or the consenting parent or guardian, is under the influence of intoxicating liquor or a controlled substance.

(4) Gloves -

(a) The operator shall wear clean, intact, single-use gloves when performing body art procedures.

(b) Under no circumstances shall a single pair of gloves be used on more than one person. Gloves shall be changed if they become contaminated by contact with any non-clean surfaces or objects or contact with a third person. The gloves shall be discarded at a minimum after the completion of each procedure on an individual client and hands washed prior to donning the next set of gloves.

(c) The use of single-use gloves does not preclude or substitute for hand washing procedures as part of a good personal hygiene program.

(d) If, while performing a body art procedure the operator's glove is pierced, torn or otherwise contaminated, the contaminated glove shall be immediately discarded and the hands washed thoroughly (see section (5)(b) of this rule) before a new pair of gloves is applied. Any item or instrument used for body art, which is contaminated during the procedure, shall be discarded and replaced immediately with a new disposable or sterilized item or a new sterilized instrument before the procedure resumes.

(5) Hygienic practices –

(a) The operator or technician shall maintain a high degree of personal cleanliness, conform to hygienic practices, and wear clean clothes when performing body art procedures.

(b) Before performing body art procedures, the operator or technician must thoroughly wash their hands in hot running water with liquid soap, then rinse hands and dry with disposable paper towels. This shall be done as often as necessary to remove contaminants. Disposable liquid soap dispensers shall not be refilled.

(c) Smoking, eating or drinking by anyone is prohibited in the work area where body art is performed.

(6) Operator information required - The following information shall be kept on file on the premises of a body art facility and available for inspection by the Department:

(a) Full name and exact duties of each body art operator/technician;

(b) Date of birth of each body art operator/ technician;

(c) Gender of each body art operator/technician;

(d) Home address of each body art operator/ technician;

(e) Identification photos of each body art operator/ technician;

(f) Social security number of each body art operator/technician. Except that, refusal by the employee to give the social security number will not result in denial of any right, privilege or benefit.

(7) Procedures information required - A complete listing of all body art procedures performed shall be kept on file on the premises of a body art facility and available for inspection by the Department.

(8) Inventory information required - An inventory of all instruments and body jewelry, all sharps, and all inks used for any and all body art procedures, including names of manufacturers and serial or lot numbers, if applicable, shall be kept on file on the premises of a body art facility and available for inspection by the Department. Invoices or orders shall satisfy this requirement.

(9) Biohazard waste and sharps disposal –

(a) Biohazard waste, as defined in these rules, shall be disposed in accordance with all applicable local, state, and federal laws, rules, and ordinances, to include, at a minimum, 29 CFR Part 1910.1030, Occupational Exposure to Bloodborne Pathogens.

(b) Waste which does not release liquid blood or body fluids when compressed or does not release dried blood or body fluids when handled may be placed in a covered receptacle and disposed through normal, approved disposal methods. Storage of such waste on-site shall not exceed the period specified by the Department or more than a maximum of 30 days, as specified in 29 CFR Part 1910.1030 whichever is less.

(c) Sharps ready for disposal shall be disposed of in approved biohazard sharps containers.

(10) Skin condition of clients and operators -

(a) Any skin or mucosa surface to receive a body art procedure shall be free of rash or any visible infection.

(b) The skin of the operator shall be free of rash or infection. No person or operator affected with boils, infected wounds, open sores, abrasions, or weeping dermatological lesions shall work in any area of a body art facility in any capacity in which there is a likelihood that they could contaminate body art equipment, supplies or working surfaces with body substances or pathogenic organisms.

(11) Hepatitis B vaccination - Proof shall be provided upon request of the Department that all operators and technicians have either completed or were offered and declined, in writing, the hepatitis B vaccination series. This offering should be included as a pre-employment requirement. Documentation of immunity, based on a blood test of the operator, in written form and from an approved laboratory, may be used for this requirement of proof.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.04 Exemptions.

(1) Physicians - Physicians licensed by the State of Alabama who perform body art procedures as part of patient treatment are exempt from these rules.

(2) Ear piercing - Ear piercing is exempt from these rules. This does not prohibit the Department from investigating consumer complaints relating to alleged misuse or improper disinfection of ear piercing systems.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.05 Client Information And Site Care Information.

(1) Information given prior to a procedure -

(a) Body art facilities shall prominently display a Disclosure Statement which advises the public of the risks and possible consequences of body art services. The Disclosure Statement shall be posted in a conspicuous place in the facility’s waiting or general public area, and easily seen by potential clients wanting to receive a body art procedure.

(b) The Disclosure Statement shall include, at a minimum, the following wording in bold type:

"There may be risks associated with the procedures of commercial body art which includes permanent tattoos, body piercing and permanent cosmetic application, that may adversely affect the healing process, or may be a concern due to potential disease transmission, if you have, or have had, any of the following conditions:

1. History of Hepatitis B or Hepatitis C;

2. HIV/AIDS;

3. Diabetes;

4. History of hemophilia or any other blood disorder/disease;

5. History of skin diseases or skin lesions;

6. History of sensitivities to soaps, disinfectants, etc.;

7. History of allergies or adverse reactions to pigments, dyes, latex, etc.;

8. Tuberculosis;

9. Immune disorders;

10. History of epilepsy, seizures, fainting, or narcolepsy;

11. Scarring (keloids);

12. History of heart murmur or any heart disease/ condition;

13. History of taking medications such as anticoagulants that thin the blood and/or interferes with blood clotting;

14. Pregnancy or breast feeding/nursing.

(c) In the event a body piercing procedure is to be performed which involves the oral area ("oral piercing"), the client should be given oral piercing information such as shown in Appendix C.

(2) Site care information - A written information sheet, shown in Appendix D, with instructions for general site care which shall be provided as a minimum to each client. The facility may provide additional information as it deems appropriate. The body art procedure site care information shall be provided to each client by the operator upon completion of the procedure. The written information sheet shall also contain the name, address and phone number of the body art facility.

(b) The written information shall advise the client to consult a physician at the first sign of infection; such as redness, swelling, drainage, prolonged pain at the body art procedure site, or onset of fever.

(3) Reporting known infections, complications, or diseases required - A person who owns or operates a licensed tattoo facility shall, within 24 hours of becoming aware that an individual tattooed, branded, or body pierced at the tattoo facility is infected with a communicable disease, notify the department or a local county health department.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.06 Client Health.

(1) Client health medical information form -

(a) In order for the operator or technician to properly evaluate the client's medical condition prior to receiving a body art procedure and not violate the client's rights or confidential medical information, a written request for medical information shall be given to the client. The request for medical information shall include, at a minimum, the conditions noted on the Model Medical History shown in Appendix E.

(b) The operator should ask the client to sign this form confirming that the information was obtained or attempted to be obtained.

(c) This form shall be signed and dated by both parties, with a copy given to the client and the operator retaining the original with all other required records.

(d) Nothing in this rule shall be construed to require the operator to perform a body art procedure upon a client.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.07 Records Retention.

(1) Client records required - The body art facility shall keep a record of all persons who have had body art procedures performed. The record shall include the name, date of birth, and address of the client, the date of the procedure, name of operator who performed the procedure(s), type and locations of procedure(s) performed, signature of client and if the client is a minor, proof of parental or guardian consent, that is, signature.

(2) Record retention time - Such records, any release forms, and all materials signed by the client, shall be retained permanently and made available to the Department upon request. The records for the previous three years shall be kept on the premises of the body art facility; records older than three years may be kept offsite provided they are readily accessible upon request of the Department. The Department and the body art facility shall keep such records confidential.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.08 Preparation And Care Of The Body Art Area.

(1) Skin preparation - If shaving is necessary, single use disposable razors with single service blades shall be used and discarded after each use. Following shaving, the skin and surrounding area shall be cleaned with soap and water or an approved surgical skin preparation, depending on the type of body art to be performed. When shaving is not done, the immediate and surrounding area of the skin where the body art procedure is to be placed shall be cleaned with soap and water or an approved surgical skin preparation. Cleansing pads shall be discarded after a single use.

(2) Supplies contaminated with blood - In the event of blood flow, all products used to check the flow of blood or to absorb blood shall be single-use and disposed of immediately after use in appropriate covered containers, unless the disposal products meet the definition of biomedical waste. 420-3-23-.09 Sanitation and sterilization procedures.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.09 Sanitation And Sterilization Procedures.

(1) Instrument cleaning - All non-single use, non-disposable instruments used for body art shall be cleaned thoroughly after each use by scrubbing with an appropriate soap or detergent solution and hot water or follow the manufacturer's instructions to remove blood and tissue residue, and placed in an ultrasonic unit which shall also be operated in accordance with manufacturer's instructions.

(2) Instruments packaged following cleaning - After cleaning, all non-disposable instruments used for body art shall be packaged individually in peel-packs and subsequently sterilized. All peel-packs shall contain either a sterilizer indicator or internal temperature indicator. Peel-packs must be dated and may be used as long as the package integrity has not been breached.

(3) Instrument sterilization -

(a) All cleaned, non-disposable instruments and jewelry used for body art shall be sterilized in a steam autoclave or dry heat sterilizer. Equipment used for sterilization shall be used, cleaned, and maintained according to the manufacturer's instructions. A copy of the manufacturer's recommended procedures for the operation of their sterilization unit must be available for inspection by the Department.

(b) The use of equipment not specifically designed for medical instrument sterilization, such as, but not limited to, food pressure cookers, microwave ovens, and baking ovens, is prohibited.

(4) Package integrity - Sterile equipment shall not be used if the package integrity has been breached. If the package integrity is breached, the equipment shall be removed from the package, and cleaned and sterilized as required in sections (1) and (2) of this rule.

(5) Location of sterilizers, when required - Sterilizers shall be located away from work stations or areas frequented by the public. If the body art facility uses all single use, disposable instruments and products, and utilizes sterile supplies, an autoclave shall not be required.

(6) Sterilizer efficacy testing - Each holder of a license to operate a body art facility shall demonstrate that the sterilizer used is capable of attaining sterilization by conducting monthly spore destruction tests. These tests shall be verified through an independent laboratory. The license shall not be issued or renewed until documentation of the sterilizer's ability to destroy spores is determined by the Department. These test records shall be retained by the operator for a period of three (3) years and made available to the Department upon request.

(7) Storage of sterilized instruments and other instruments and supplies - Unless received from the manufacturer as a sterile instrument and in a package maintaining sterility and package integrity, all needles used in tattooing and cosmetic tattooing shall be cleaned and sterilized prior to use and stored in peel-packs. After sterilization, the instruments used for tattooing/body piercing shall be stored in a dry, clean cabinet or other tightly covered container reserved for the storage of such instruments. All other instruments and supplies shall be stored in clean, dry and covered containers.

(8) Sanitization and disinfection of surfaces - Procedure surfaces, counter tops used for equipment assembly, and any other similar surfaces where necessary shall be cleaned and sanitized with a disinfectant solution after each client.

(9) Reusable cloth items - Reusable cloth items shall be mechanically washed with detergent and dried after each use. The cloth items shall be stored in a dry, clean environment until used. Soiled cloth items shall be stored in a manner to preclude contamination of any clean items, equipment, or instruments.

(10) Clean techniques required - All instruments used for tattooing/body piercing shall remain stored in sterile packages until just prior to performing a body art procedure. When assembling instruments used for performing body art procedures, the operator shall wear disposable single-use gloves and use clean techniques to ensure that the instruments and gloves are not contaminated.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.10 Inks, Dyes, Pigments, Needles And Equipment.

(1) Use according to manufacturer’s directions - All inks, dyes, pigments, needles and equipment shall be specifically manufactured for performing body art procedures and shall be used according to manufacturer's instructions and standard professional practice.

(2) Ink used during a procedure - Immediately before applying a tattoo, the quantity of the dye to be used shall be transferred from the dye bottle and placed into single-use paper or plastic cups. Upon completion of the tattoo, these single cups and their contents shall be discarded.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.11 Single-Use Items.

(1) Use restricted – Single-use items shall not be used on more than one client for any reason. After use, all single-use needles, razors and other sharps shall be immediately disposed of in approved sharps containers.

(2) Products applied to the skin -

(a) All products applied to the skin, including body art stencils, shall be single-use and disposable.

(b) Acetate stencils shall be allowed for re-use if sanitization procedures are performed between uses.

(c) Petroleum jellies, soaps and other products used in the application of stencils shall be dispensed and applied on the area to be tattooed with sterile gauze or in a manner to prevent contamination of the original container and its contents. The gauze shall be used only once and then discarded.

(d) The operator shall use only single-use sterile gauze and single-use antibacterial ointments to cover the procedure site(s).

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.12 Physical Facilities.

(1) Plans required - Body art facilities applying for a license after adoption of these rules shall submit a scale drawing and floor plan of the proposed facility for a plan review by the Department, as part of the license application process.

(2) Floors, walls, and ceiling -

(a) All walls and floors of the procedure area of a body art facility shall be smooth, free of open holes or cracks, washable and in good repair. Ceilings in all procedure areas shall be maintained in good repair with no open holes. Walls in waiting rooms and non-procedure areas may have decorative attachments if the wall and decorations are kept clean.

(b) Carpeting is prohibited as a floor covering in the body art procedure area.

(c) Walls, floors and ceilings in the body art facility shall be maintained in a clean condition.

(3) Water supply -

(a) Water used for the sanitary operations of the body art facility shall be provided from a source operated and constructed according to law.

(b) At least one water sample shall be collected annually from any body art facility if the body art facility’s water supply is not from a source approved by the Alabama Department of Environmental Management.

(c) If the water sample results show coliform present as reported by the Alabama Department of Public Health Bureau of Clinical Laboratories, a resample shall be taken within seven days of the report being received by the county health department. Whenever two consecutive samples taken on separate days show coliform present, body art facility’s license shall be suspended in accordance with appropriate administrative procedures. A sample result of coliform absent with no confluent growth is required prior to reinstatement of the license.

(4) Sewage disposal – All sewage, and liquid waste such as mop water, shall be disposed of by a public sewerage system or by a sewage disposal system constructed and operated according to law.

(5) Sinks and toilet facilities -

(a) A readily accessible handwashing sink with hot and cold running water, under pressure, dispensed through a mixing valve, with no aerator, preferably equipped with wrist or foot operated controls, and supplied with liquid soap in disposable dispensers and disposable paper towels at the sink, shall be provided convenient to the work area within any procedure room in the body art facility.

(b) When there are multiple procedure areas or operators in one room, one handwashing sink shall serve no more than three (3) operators or three (3) work areas.

(c) Toilet facilities shall be installed according to law; shall be the number required by law as enforced by local plumbing officials, but at least one; shall be under the care and control of the body art facility operator; and shall be accessible to employees at all times.

(d) Each toilet room shall have a handwashing sink, designed and supplied as required in section (3)(a) of this rule, inside the toilet room or outside the toilet room immediately adjacent to the toilet room door.

(e) Handwashing sinks shall be used for no other purpose.

(f) A utensil sink with hot and cold water under pressure, supplied through a mixing valve with no aerator, shall be provided for washing reusable instruments or other reusable items.

(g) A service sink or utility sink, with at least hot water under pressure, shall be provided for the disposal of liquid waste.

(6) Procedure surfaces - All procedure surfaces, including client chairs and/or benches, shall be of such construction and maintained to be easily cleaned and sanitized with a disinfectant solution after each client.

(7) Separation from other areas - All body art facilities shall be completely separated by solid partitions or by walls extending from floor to ceiling, from any room used for human habitation, or any room used for living or sleeping quarters or a bathroom used for a personal residence, or from a food establishment or room where food is prepared, a hair salon, retail sales, or other such activity which may cause potential contamination of work surfaces.

(8) Procedure (work station) area - There shall be a minimum of thirty-five (35) square feet of floor space at each work station in the body art facility unencumbered by non-portable furniture or equipment. Each body art facility shall have an area which may be screened from public view for clients requesting privacy. Multiple body art stations shall be separated by dividers, curtains or partitions, at a minimum.

(9) Ventilation - The facility shall be well-ventilated.

(10) Lighting - The facility shall be provided with an artificial light source equivalent to at least twenty (20) foot candles three (3) feet off the floor, except that at least 100 foot candles shall be provided at the level where the body art procedure is being performed, and where instruments and sharps are assembled and/or processed.

(11) Insects, vermin, and rodents prohibited - Effective measures shall be taken by the body art operator to protect the entrance into the facility and the breeding or presence on the premises of insects, vermin and rodents. Insects, vermin and rodents shall not be present in any part of the facility, its appurtenances or appertaining premises.

(12) Animals prohibited - No animals of any kind shall be allowed in body art facility except service animals used by persons with disabilities shall be allowed. Fish aquariums may be allowed in waiting rooms and non-procedural areas.

(13) Refuse containers - At least one covered waste receptacle shall be provided in each operator work area and each toilet room. Receptacles in the operator work area shall be emptied daily and solid waste shall be removed from the premises at least weekly. All refuse containers shall be lidded, cleanable and kept clean.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.13 Licenses And Permits.

(1) Body art facility licenses required -

(a) No person shall operate a body art facility until obtaining a license from the Department. Any person desiring to operate a body art facility shall make written application for a license on forms provided by the Department. Such application shall include the name and address of each applicant, the physical location of the proposed body art facility, the type of all body art procedures proposed to be conducted at the facility, and the signature of each applicant. The license shall be issued on forms provided by the Department.

(b) If the Department determines that the application is complete and the body art facility proposed or operated by the applicant meets the requirements of these rules, the Department shall issue a license to the applicant for the operation of that body art facility.

(c) Licenses shall automatically expire on the date upon which state, county, and municipal annual privilege licenses expire or on a date designated by the local county health department and shall be renewable annually upon written application from the operator not less than thirty (30) days prior to expiration.

(d) The body art facility applicant shall pay a fee as set by law for each body art facility license, which is:

1. $250.00 for the initial annual license.

2. $200.00 for a one-year renewal of an annual license.

3. $50.00 for a temporary license.

(e) Body art facility license fees are not prorated.

(f) A license for a body art facility shall not be transferable from one place or person to another.

(g) A current body art facility license shall be displayed in a conspicuous place within the customer service area of the body art facility where it may be readily observed by clients upon entering the facility.

(2) Operator permits required -

(a) The holder of a body art facility license shall hire, employ, or use operators or technicians who have complied with the operator permit requirements of these rules.

(b) No person shall practice body art procedures without first obtaining an operator permit from the Department.

(c) The operator permit shall be valid from the date of issuance and shall automatically expire at the end of the facility license year following the current year when issued unless revoked sooner by the Department in accordance with these rules. Application for operator permits shall include:

1. Name;

2. Date of birth;

3. Sex;

4. Residence address;

5. Mailing address;

6. Phone number;

7. Place(s) of employment as an operator;

8. Years experience;

9. Social security number. Provided that, refusal by the employee to give the social security number will not result in denial of any right, privilege or benefit;

10. Proof of attendance within the 36 months prior to making application at a bloodborne pathogen training program (or equivalent), given or approved by the Department, to include demonstration of knowledge of the following subjects:

(i) Anatomy;

(ii) Skin diseases, disorders, and conditions (for example, diabetes) which may affect the skin;

(iii) Infection control procedures including waste disposal, hand washing techniques, sterilization equipment operation and methods, and sanitization/disinfection/ sterilization methods and techniques;

(iv) Facility safety and sanitation.

(d) Knowledge of the subjects in section 420-3-23-.13(2)(c)10 must be demonstrated through submission of documentation of attendance or completion of courses approved or given by the Department prior to issuance of the operator's permit. Examples of courses approved by the Department would include such courses as Prevention of Disease Transmission and Bloodborne Pathogen Training.

(e) No operator permit shall be issued unless, following reasonable investigation by the Department, the body art operator has demonstrated compliance with the provisions of this section and all other provisions of these rules.

(f) All operator permits shall be conditioned upon continued compliance with the provisions of this section as well as all applicable provisions of these rules.

(g) All operator permits shall be posted in a conspicuous place within the customer service area where they may be readily observed by clients upon entering the body art facility.

(3) Existing body art facilities and operators -

(a) Body art facilities operating at the time of the enactment of these rules, as evidenced by the possession of a current and valid business license, shall, within 30 days of the effective date of these rules, make application to the Department for a body art facility license and pay the fee for a new license as required in this rule. This first license for these existing facilities shall be considered a Provisional License and shall not be renewed unless all the requirements of these rules are met by the license expiration date. In the event all the requirements of these rules are not met by the time the Provisional License expires, or application for a Provisional License is not made within 30 days of the effective date of these rules, the body art facility shall not be considered an existing facility and shall make application for a license as a new facility.

(b) Operators conducting body art procedures at the time of the enactment of these rules shall make application to the Department for an Operators Permit and obtain an Operators Permit within 6 months of the effective date of these rules.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.14 Temporary Facility License Or Operator Permit.

(1) Licenses and permits -

(a) Temporary body art facility licenses and, when required, operator permits, may be issued for body art services provided outside of the physical site of a fixed licensed facility for the purposes of product demonstration, industry trade shows or for educational reasons.

(b) Temporary licenses issued under the provisions of these rules may be suspended by the Department for failure of the holder to comply with the requirements of these rules.

(c) All facility licenses and operator permits and the disclosure notice must be readily visible to clients.

(2) Requirements - Temporary operator permits and/or facility licenses shall not be issued unless:

(a) The applicant furnishes proof of compliance with 420-3-23-.13(2) relating to operator's permits and/or

(b) The applicant is currently affiliated with a fixed location or permanent facility which, where applicable, is permitted by the appropriate State and/or local jurisdiction; and

(c) The temporary site complies with section (9) of this rule.

(3) Training - In lieu of attendance at a bloodborne pathogens training program approved by the Department within the past three (3) years as specified in 420-2-23-13(2)(c) above, the applicant may furnish proof of attendance at equivalent training which is acceptable to the Department.

(4) Time limit - Temporary body art facility licenses and/or operator permits expire after fourteen (14) days or the conclusion of the special event, whichever is less.

(5) Fee required - Temporary body art facility licenses shall not be issued unless the applicant has paid the fee set by law.

(6) Non-transferable - The temporary body art facility license or operator permit shall not be transferable from one place or person to another.

(7) License and permits posted - The temporary body art facility license and operator permit shall be posted in a prominent and conspicuous area where they may be readily seen by clients upon entering the facility.

(8) Temporary Operator Permit Requirements -

(a) A temporary permit may be issued by the Department for educational, trade show or product demonstration purposes only. The permit may not exceed fourteen (14) calendar days.

(b) A person who wishes to obtain a temporary demonstration permit must submit the request in writing for review by the Department, at least thirty (30) days prior to the event. The request shall specify:

1. The purpose for which the permit is requested;

2. The period of time during which the permit is needed (not to exceed fourteen (14) calendar days per event), without re-application;

3. The fulfillment of temporary operator requirements as specified in section (2) of this rule;

4. The location where the temporary demonstration will be conducted.

(9) Temporary Establishment Physical Facilities -

(a) The temporary demonstration project must be contained in a completely enclosed, non-mobile facility (that is, inside a permanent building).

(b) Except as otherwise provided in this rule, the temporary body art facility and operator shall comply with all of the requirements of these rules, including but not limited to:

1. Conveniently located handwashing facilities with liquid soap, paper towels and hot and cold water under adequate pressure shall be provided; along with sanitary drainage in accordance with local plumbing codes.

2. A minimum of eighty (80) square feet of floor space;

3. At least one hundred (100) foot candles of light at the level where the body art procedure is being performed.

4. Facilities to properly sterilize instruments with evidence of a spore test performed on sterilization equipment thirty (30) days or less prior to the date of the event, shall be provided; or only single use, prepackaged, sterilized equipment obtained from reputable suppliers or manufacturers shall be allowed;

5. Ability to properly clean and sanitize the area used for body art procedures. The facility where the temporary demonstration is proposed shall be inspected by the Department and a license issued prior to any body art procedures being performed.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.15 Prohibitions.

(1) Prohibited acts include, but are not limited to, the following:

(a) Performing body art on any body part of a minor without the informed written consent of the parent or legal guardian of such minor. This consent is to be given in person to the operator or responsible person at the facility by the parent or legal guardian at the time the tattooing or piercing is to commence.

(b) Performing body art on a person who, in the opinion of the operator is inebriated or appears to be under the influence of alcohol or drugs.

(c) Owning, operating or soliciting business as a body art facility or operator without first obtaining all necessary permits and approvals from the Department, unless specifically exempted by these rules.

(d) Obtaining or attempting to obtain any body art facility license or operator permit by means of fraud, misrepresentation or concealment.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.16 Compliance And Enforcement.

(1) Inspection frequency -

(a) A representative of the Department shall properly identify him or herself upon entering a body art facility to make an inspection. Inspections shall be conducted at least every 180 days or as often as necessary throughout the year to ensure compliance with these rules.

(b) The routine inspection frequency shall be determined by the compliance status found on inspection as below. Nothing in this section precludes the Department from issuing an immediate Notice of Intent to Suspend/Revoke order, or issuing an emergency order to immediately cease operation or cease using a particular item of equipment or a particular process, if necessary in order to protect the public health.

(c) A routine re-inspection shall be conducted within 180 days when:

1. No critical items were found in non-compliance or any critical items found in non-compliance are corrected during the inspection, or

2. No second-time repeat non-critical items were found in non-compliance.

(d) A compliance check shall be conducted within 30 days when:

1. One or more critical items are found in non-compliance and are not corrected during the inspection, or one or more repeat corrected critical items from the previous inspection were found in non-compliance regardless of being corrected during the current inspection, or

2. One or more second-time repeat non-critical items from the previous routine inspection were noted in non-compliance regardless of being corrected during the current inspection.

(e) Whenever a compliance check to determine correction of any item finds the item in continuing non-compliance; a Notice of Intent to Suspend or Revoke the license or permit shall be issued to the person in charge at the body art facility. If the item in non-compliance and being the cause for issuance of the Notice is corrected, the body art facility shall retain the inspection status but shall be re-inspected within 30 days.

(2) Inspection report -

(a) The original of the inspection report (see Appendix F) shall be furnished to the permit holder or operator of the body art facility, with the Department retaining possession of a copy.

(b) The inspection report shall designate the compliance status of the body art facility as Routine re-inspection or Compliance Check Necessary, based on the result of the inspection as specified in 420-3-23-.16(1).

(3) Correction of non-critical violations -

(a) Upon finding a violation of any provision of these rules that is deemed a non-critical item, the Department shall advise the licensee or permitted operator, in writing, of its findings and instruct the operator to correct such violations within a reasonable period of time, but no later than the time of the next routine inspection.

(b) In the event a non-critical violation is not corrected by the time of the next routine inspection, or is the same violation as on the preceding routine inspection, it shall be noted on the inspection report as a repeat violation. In the event one or more non-critical items are found in violation on a second consecutive routine inspection, they shall be noted on the inspection report as a second repeat violation, and shall be corrected as required for critical items in 420-3-.16(4).

(4) Correction of critical violations -

(a) Violation of any provision of these rules that is deemed a critical item should be corrected immediately, during the course of the inspection, but in any event within 30 days following the inspection.

(b) In the event the violation cannot be corrected during the course of the inspection, or if the critical violation is the same as on the immediately preceding inspection and was corrected at that time but is now in violation again, notice of intent to suspend the body art facility license or operator permit, or both, shall be issued by the Department representative conducting the inspection. The body art facility license holder or permit holder may request a hearing on the notice of intent to suspend in accordance with these rules.

(5) Suspension of licenses and permits -

(a) Licenses and permits issued under the provisions of these rules may be suspended temporarily by the Department for failure of the holder to comply with the requirements of these rules or for repeated or critical violations of any of the requirements if these rules.

(b) Whenever the Department is aware of, or has reasonable cause to suspect that, 1) a communicable disease has been, or may be, transmitted by an operator to a client; or 2) there is use of unapproved or malfunctioning equipment; or 3) insanitary or unsafe conditions exist which may adversely impact the health of the public; the Department may, upon written notice to the owner or operator, do any or all of the following:

1. Issue an order excluding any or all operators from the licensed body art facility who are responsible, or reasonably appear responsible, for the transmission of a communicable disease until the Department determines there is no further risk to public health.

2. Issue an order to immediately suspend or revoke the license of the body art facility until the Department determines there is no further risk to the public health. Such an order shall state the cause for the action.

(6) Reinstatement - Any person whose license or permit has been suspended may, at any time, make application for reinstatement of the permit. Within ten (10) days following receipt of a written request, including a statement signed by the applicant that in his opinion the conditions causing the suspension have been corrected, the Department shall re-inspect the body art facility or evaluate documentation provided by an operator. If the applicant is in compliance with the provisions of these rules, the license or permit will be reinstated.

(7) Revocation -

(a) For failure to comply with a notice of license or permit suspension, or for repeated or critical violations of any of the requirements of these rules, or for interference with Department personnel in the performance of their duties, the license or permit may be permanently revoked after a hearing. Before taking such action, the Department shall notify the license or permit holder or operator in writing, stating the reasons for which the license or permit is subject to revocation and advising the license or permit holder or operator of the requirements for filing a request for a hearing. A license or permit may be suspended for cause, pending its revocation or hearing relative thereto.

(b) A revocation shall last no less than 90 days. After that time, any person whose license or permit has been revoked may make application for a new license or permit. If the applicant is in compliance with the provisions of these rules as required for new applicants, the new license or permit will be issued.

(8) Service of notice - Whenever a licensee or permit holder or operator has failed to comply with any notice issued under the provisions of these rules, the operator shall be notified in writing that the license or permit is, upon service of this notice, immediately suspended. The notice shall inform the license holder or permitted operator that an opportunity for a hearing will be provided if a written request for a hearing is filed with the Department within fifteen (15) days. Service of notice may be accomplished by mailing the notice, regular mail, to the address listed on the body art facility license or operator permit application.

(9) Hearings -

(a) A person who, 1. after proper application, is denied a permit, license, or authorization; or 2. is in possession of a valid permit, license, or authorization, and is notified in writing of the intent to suspend, revoke, or deny renewal of said permit, license, or authorization, shall be provided the reasons therefore and may, within 15 days following receipt of said notice, apply in writing for an informal hearing to the Health Officer, or his/her designee, of the county from which said denial(s) or notice of intent was issued, in accordance with the Rules of the State Board of Health governing appeals.

(b) If, after the informal hearing, the matter is not resolved to the satisfaction of the aforesaid person, written appeal, in accordance with the Rules of the State Board of Health governing appeals, may be made to the State Health Officer within 15 days following said hearing. This appeal shall be sent directly to the State Health Officer, State Department of Health, P.O. Box 303017, Montgomery, Alabama 36130-3017, with a copy furnished to the local county health department of the county from which said denial or notice of intent was issued.

(10) Emergency suspension -

(a) Notwithstanding any other provision of these rules, whenever the Department finds insanitary or other conditions which, in the judgment of the designee of the Department authorized to conduct inspections of body art facilities, constitute a substantial hazard to the public’s health, he or she may, without warning, issue a written notice to the license holder or permit holder citing such conditions, specifying the corrective action to be taken, and specifying the time period within which such action shall be taken.

(b) If deemed necessary, such order shall state that the license and/or permit is immediately suspended, and all body art procedures shall be immediately discontinued.

(c) Any person to whom such order is issued shall comply immediately therewith.

(11) Penalty -

(a) A person who violates any provision of these rules shall be guilty of a Class C misdemeanor, punishable by imprisonment for not more than 90 days, or a fine of not more than $100.00, or both, for each violation.

(b) In addition to any other enforcement action authorized by law, a person alleging a violation of Act 321-2000 may bring a civil action for appropriate injunctive relief.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.17 Department Personnel Competency Requirement.

(1) Department personnel performing environmental health/sanitary evaluations or complaint investigations of body art facilities shall meet the same requirements as specified for operators in section 420-3-23-.13(2)(c)10 of these rules prior to assuming responsibilities for this program.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

420-3-23-.18 Repealer. Any rules promulgated by the State Board of Health which are in conflict with these rules, or with any portion thereof, are hereby expressly repealed.

Authors: Ronald Dawsey, Charlotte Denton

Statutory Authority: Code of Ala. 1975, §22-17A-7.

History: New Rule: Filed March 15, 2001; effective April 19, 2001; operative May 4, 2001.

APPENDIX A

CRITICAL ITEMS

Critical items are those sections of these rules pertaining to:

Body art procedures performed on minors;

Body art procedures performed on clients under the influence;

Use of gloves by the operator;

Hygienic practices by the operator;

Operator’s hands washed and clean;

Biohazard and sharps disposal ;

Skin condition of the operator and client;

Evidence of Hepatitis B vaccination acceptance/declination for the operator on file and available;

Site care information provided to clients as required;

Required client health information requested before any procedure;

Skin prepared as required before any procedure;

Instruments used for body art properly cleaned, sterilized, packaged, dated, stored, and used;

Sterilizer tested (spore destruction) by independent 3rd party and documentation available;

Sterilizer manufacturer’s instructions for use available and followed;

Clean techniques used for assembly of instruments used for body art prior to beginning procedure;

Inks, dyes, pigments, needles, other equipment used for body art procedures approved and properly used;

Single-use items used as required;

Water supply from approved source;

Sewage disposal approved;

Waste water disposed through service sink;

Toilet(s) on premises, under care and control of operator, accessible, supplied and designed as required;

Handwashing sinks used, provided, accessible, supplied, designed as required;

Utensil washing sink used, provided, accessible, supplied, and designed as required;

Service sink used, provided, accessible, supplied, and designed as required;

Insects, rodents, vermin, other animals not present unless specifically allowed by these rules;

Display for public view of license, permits, disclosure statement.

APPENDIX B

CONSENT FOR MINOR

I, _________________________________, attest that I am the legal guardian of ___________________________________ who is currently __________ years of age and that I give him/her consent to have the following procedure(s):

________________________________________________________________

_______________________________________________________________.

I further attest that I have been informed of the possible risks involved with this procedure and of its permanence by the undersigned individual performing the procedure or by an employee or agent of the facility in which the procedure will be performed.

______________________________________________________________

Signature of Guardian

_______________________________________________________________

Address

________________________________________________________________

City, State, Zip Code

Date _______________________

___________________________________________________

Signature of employee or Agent

_____________________________

Date

As a minor, I assent to this procedure. Yes______ No_______

_____________________________________________ _______________

Signature of minor having body art procedure Date

APPENDIX C

MODEL

ORAL PIERCINGS INFORMATION SHEET

(Information from the American Dental Association)

Oral piercings, which involve the tongue, lips, cheeks, uvula, or a combination of sites, have been implicated in a number of adverse oral and bodily conditions. The piercing of oral structures presents unique risks due to the nature of the environment, the rich blood supply of the tissues, the presence of vast amounts of bacteria and other organisms, and the important functional roles the mouth plays in the complex processes of digestion, respiration, sensory perception, and speech.

Common symptoms following oral piercing include pain, swelling, bleeding, and increased salivary flow. Documented health risks include infection chipping or fracturing of teeth, gum stripping and recession, rapid development of bone loss of the lower front teeth, broken fillings or crowns, difficulty with eating and speech, and the swallowing or aspiration of jewelry.

Serious and life-threatening complications of infections have rarely been documented following oral piercings. These include development of infection which spreads to the heart, which required hospitalization; and one case of a compromised respiratory airway, making it difficult to breath.

Appendix D

SITE CARE INSTRUCTIONS

GENERAL INFORMATION:

Healing time for piercing and tattooing varies from person-to-person. The rate of infection is minimal if the aftercare is followed appropriately. It is very important to remember not to touch the pierced or tattooed site without first washing your hands. Normal body reactions to piercing and/or tattooing may include: redness, swelling, and/or minor discomfort at the site. If after 48 hours more severe complications occur (increased redness, swelling or hardness at the site, pus-like drainage, onset of fever, and/or prolonged pain at the site or respiratory difficulty following tongue piercing), contact your personal physician or dentist (following oral piercing).

PIERCING INFORMATION:

1. Do NOT remove jewelry except as instructed. Many people think that jewelry can be removed after a few days or weeks. This is not true. Problems with re-insertion and with the healing process may occur if jewelry is removed too soon. Usual recommendations are for jewelry NOT to be removed for at least 6 months to a year. If jewelry must be removed for medical reasons, call the piercer or your physician and arrange to have it removed.

2. Never handle the piercing without first washing your hands.

3. Avoid being too rough with the piercing. This could traumatize the tissue at the site.

4. Clean the pierced site as instructed. Do not over-clean using too many or inappropriate cleaning agents.

5. Avoid swimming in rivers, lakes, or hot tubs until the piercing site has completely healed.

TATTOOING INFORMATION:

1. Keep the new tattoo site bandaged for approximately 2 hours.

2. Wash hands prior to changing bandage.

3. Carefully remove bandage and wash entire area with a mild soap and cool water. Dry the area and apply an antibiotic ointment using a very thin coat. Apply 2-4 times daily for at least three days.

4. Do NOT re-bandage the tattoo, as it could stick to the bandage and damage could occur.

5. Avoid sunburn, salt or chlorine water, or hot tubs until your tattoo is completely healed.

6. In the event mild scabbing occurs, DO NOT pick at or attempt to "wash off". Allow the scabs to slough off naturally. You may apply a mild skin lotion to keep "flaking" to a minimum.

7. Note: In the first weeks, the colors in your new tattoo may look "hazy" or not as bright as they did when it was first applied. Do not be alarmed, it is a normal course of healing and will clear up in a few short weeks.

IMPORTANT: ANY COMPLICATIONS OR SIGNS OF INFECTION SHOULD BE REPORTED IMMEDIATELY.

(Additional specific information sheets may be given to you as needed.)

Appendix E

MEDICAL HISTORY

Please Answer The Following Questions:

Do you presently have, or have you ever had:

1. Hepatitis B? Yes___ No___

2. Hepatitis C? Yes___ No___

3. HIV/AIDS? Yes___ No___

4. Diabetes? Yes___ No___

5. History of hemophilia or any other blood disorder/ disease? Yes___ No___

6. Skin diseases or skin lesions? Yes___ No___

7. Sensitivities to soaps, disinfectants, etc.? Yes___ No___

8. History of allergies or adverse reactions to pigments, dyes, latex, etc.? Yes___ No___

9. Tuberculosis? Yes___ No___

10. Immune disorders? Yes___ No___

11. History of epilepsy, seizures, fainting, or narcolepsy? Yes___ No___

12. Scarring (keloids)? Yes___ No___

13. History of heart murmur or any heart disease/condition? Yes___ No___

14. History of taking medications such as anticoagulants that thin the blood and/or interferes with blood clotting? Yes___ No___

15. Are you now under the influence of alcohol or drugs? Yes___ No___

16. Are there any other medical conditions which may affect your body art healing process? Yes___ No___

17. FEMALES: Are you pregnant or breast feeding/nursing? Yes___ No___

IF YOU HAVE ANSWERED "YES" TO ANY OF THE ABOVE CONDITIONS, IT IS RECOMMENDED THAT YOU CONSULT WITH YOUR PERSONAL PHYSICIAN OR DENTIST BEFORE ANY PIERCING OR TATTOOING PROCEDURES ARE PERFORMED.

Signature:________________________________

Date:_____________________________________

Print Name:_______________________________ Date of birth:__________________

Address:____________

City, State, & Zip:___________________________________________

Phone Number: ( )-_______________________________________________

Artist:____________________________________________

For Tattooing:

Design & Body Site(s):_____________________________

For Piercing: Type Jewelry & Body Site(s):_______________________________

For Branding: Design & Body Site(s):___________________________________

COMMENTS:

APPENDIX F

BODY ART FACILITY Inspection Report

Body Art Facility Inspection Report

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