Body Art Technician Permit

FORM – English

    Required Contact Information

    Facility at which you work or intend to work as a body artist:

    Please attach a copy of your Bloodborne Pathogens Certificate to this application.This course is available through and other online providers.

    In accordance with Utah state law, by signature below, applicant consents that Bear River Health Department may conduct a criminal background check and hereby waives written notice of the same.

    Applicant further affirms by this signature that he/she has received a copy of Bear River Health Department Regulation for Body Art Facilities.

    Digital Signature

    By typing your name below, you are signing this form electronically. You agree to, and understand, all the information you are submitting: