1. a) Diabetes;

2. b) History of hemophilia (bleeding);

   1. c) History of skin diseases, skin lesions or skin sensitivities to soaps, disinfectants, etc.;
   2. d) History of allergies or adverse reactions to pigments, dyes or other skin sensitivities such as, but not limited to, latex;

3. e) History of epilepsy, seizures, fainting or narcolepsy;

   1. f) Medications used, such as anticoagulants that thin the blood and/or interfere with blood clotting;
4. g) Human immunodeficiency virus (HIV);

5. h) Hepatitis;

   1. i) Any other information that would aid us in evaluating your body art healing process."

The body artist/apprentice shall request information from all clients as follows:

"To ensure that your body art procedure heals properly, we ask that you disclose if you have or have had any of the following conditions. Disclosure does not prevent you from having a body art procedure.