Body Art Facility Plan Review

FORM – English

    Required Contact Information

    The Bear River Health Department requires a pre-construction plan review on all body art facilities opened after September 30, 2004. This plan review will ensure that all facility requirements comply with the BRHD Body Art Rule. This applies to any facility performing body art procedures to include permanent makeup, ear piercing, body piercing, tattooing, branding, and scarification. This requirement does not include medical facilities where a board certified medical practitioner (MD, DO, etc.) performs the procedure.

    Construction/Remodel Start Date

    Estimated Completion Date

    Body Art Procedures Performed at Facility (Please Check All Applicable Boxes):

    Sterilization Method:

    Plan review package must contain the following:

    ___ Floor plan to include location all of the workstations, hand wash sinks, toilets, and drains

    ___ Exposure Control Plan (As outlined in Section 17 of BRHD Regulations for Body Art Facilities)

    ___ Aftercare instructions form

    ___ Consent form

    ___ Equipment schedule listing all equipment, instruments, and materials to be used

    Max File Size: 5MB

    Max File Size: 5MB

    Max File Size: 5MB