With my signature below, I attest that I have read and fully understand this consent form and all details from above. I have provided accurate information concerning my medical history including medications that I take or any medical procedures I intend to undergo or prescriptions I intend to take. By signing below, I assume all and full responsibilities for any risks or injuries, losses. side eflects damages, that may occur as part of the procedure. I will not hold my tooth gem technician or Poly Ink Customs responsible for any conditions present at the time of treatment but not disclosed that may affect the treatment. I agree to Poly Ink Customs using any pictures and/or videos taken for social media, content, promotions, marketing and advertisement purposes. I understand that there are no refunds, and all deposits/payments are final.