Medical History Questionnaire.

How long has it been since you last ate?

Do you have any additional allergies to items such as metals, soaps, cosmetics or alcohol?

Are you currently on any medications?

Do you use any medications that might affect the healing of the body art you wish to receive?

Do you have any other medical or skin conditions that may affect the outcome of your procedure?

Are you currently on antibiotics?

Have you ever been prescribed antibiotics prior to dental or surgical procedures?

Do you have any cardiac valve disease?

Have you ever had a herpes infection at the proposed procedure site?

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