Waiver Form | Timeless By Trinh
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PMU Waiver Form: Timeless by Trinh

Date of birth
Year
Month
Day

HEALTH INFORMATION

Please answer questions below

1. Do you have any allergies? (eg. latex, needles, ink, etc.)
2. Are you currently taking any medications?
3. Do you have any medical conditions that may affect the PMU process?
4. Do you have any history of blood-borne diseases?
5. Are you pregnant or nursing?
6. Have you consumed drugs or alcohol within that last 24 hours?

ACKNOWLEDGEMENT AND CONSENT

Please review and check the box for acknowledgement.

CONTACT 

ADDRESS

3334A Yonge Street
Toronto, ON
M4N 2M4

Club D'elite 
1550 16th Ave, Unit 4
Richmond Hill, ON 

L4B 3K9

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GOT QUESTIONS? 

Timeless by Trinh 
Established 2024

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