Please fill out the Disclosure/Consent Form completely.  Disclosure/Consent Form will be kept on file at Honey Art/Medical Micropigmentation LLC.  By completing the below form we may better serve you.  Thank you.

Disclosure/Consent Form
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By typing your name above you have agreed that all information on this form are true and correct to the best of your knowledge, and discharge Honey Secunda and Medical Micropigmentation LLC from any liability.
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