Body Art Practice and Facilities 420-3-23

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420-3-23-.01 General Provisions

420-3-23-.02 Definitions

420-3-23-.03 Body Art Operator Requirements and Professional Standards

420-3-23-.04 Exemptions

420-3-23-.05 Client Information and Site Care Information

420-3-23-.06 Client Health

420-3-23-.07 Records Retention

420-3-23-.08 Preparation and Care of the Body Art Area

420-3-23-.09 Sanitization and Sterilization Procedures

420-3-23-.10 Inks, Dyes, Pigments, Needles, and Equipment

420-3-23-.11 Single-use Items

420-3-23-.12 Physical Facilities

420-3-23-.13 Licenses and Permits

420-3-23-.14 Temporary Establishment License or Operator Permit

420-3-23-.15 Prohibitions

420-3-23-.16 Compliance and Enforcement

420-3-23-.17 Department Personnel Competency Requirement

420-3-23-.18 Repealer

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establishing standards for the prevention of disease that may be associated with tattooing, body

piercing, and branding. These rules shall be interpreted and applied to protect the public

health.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

infectious materials; contaminated items that would release blood or other potentially infectious

materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or

other potentially infectious materials and are capable of releasing these materials during

handling; sharps; and any wastes containing blood and other potentially infectious materials.

procedures and, for the purpose of these rules, is an inclusive term for any procedures utilizing

individual does one or more of the following for compensation:

(a) Places an indelible mark upon the body of another individual by the insertion of a

pigment in or under the skin.

(b) Places an indelible design upon the body of another individual by production of

scars (branding).

(c) Performs body piercing.

nonmedical purpose.

iron or other instrument.

transmission of microorganisms from one person to another or from one place to another. It

includes, but is not limited to:

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(a) Meticulous handwashing with soap and water;

(b) Maintaining the sterility of supplies;

(c) Using barriers; in particular, clean, disposable, single-use gloves;

(d) Proper cleaning and preparation of the body site area; and

(e) Maintaining a clean and sanitary environment by using a detergent to remove soil

and a disinfectant agent to clean up a spill of blood or other potentially infectious materials.

permanent color or pigment in or under the skin or mucosa and that is intended to be used in

lieu of cosmetic make-up, such as permanent eyeliner or lip color.

(a) a provision of these rules that, if in non-compliance, has the potential for immediate

impact on the public health by resulting in infection of either clients or staff of a body art facility,

or disease transmission among clients or staff of a body art facility, or

(b) an administrative provision of these rules that is necessary to ascertain the

likelihood of infection or disease transmission among clients or staff of a body art facility or to

inform the public, and

(c) are referred to in Appendix A of these rules.

pathogenic microorganisms.

(a) These can be disinfectants or sanitizers that are registered with the U.S.

Environmental Protection Agency (EPA). Household bleach (sodium hypochlorite) with no

fragrance or other additives may also be used as a germicide.

(b) Over-the-counter pre-mixed bleach products can be used or a 1:100 dilution of

household chlorine bleach (5.25% sodium hypochlorite) can be made fresh daily and dispensed

from a spray bottle (500ppm, 1/4 cup per gallon of water or 2 tablespoons per quart of water).

them safe for use or handling.

Body Art Practice and Facilities 420-3-23

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devices, implements, furniture, display and storage areas, sinks and all other apparatus and

appurtenances used in connection with the operation of a body art facility.

under pressure, through a mixing valve, used solely for washing hands, arms or other portions

of the body.

100º F.

any body art procedure performed and which provides information and/or counseling on risks

and possible complications of the procedure to be performed.

other instruments that may come in contact with a client's body or possible exposure to bodily

fluids during body art procedures.

instrument into or through the skin or mucosa, or by any other means intended to puncture,

break or compromise the skin or mucosa.

Jewelry for body piercing use shall be made of surgical implant grade stainless steel; solid 14k

or 18k white or yellow gold; niobium, titanium, or platinum; which is free of nicks, scratches, or

irregular surfaces; has been properly sterilized prior to use, and has not been previously used.

The Department may approve other materials upon request and review.

operation of a tattoo facility. Approval is given in accordance with these rules and is separate

from any other licensing requirement of any local laws, rules, or ordinances.

emancipated minor is or has been married or has by court order otherwise been legally freed

from the care, custody, and control of his or her parents.

practices body art activities at a body art facility and who is responsible for compliance with

these rules, whether actually performing body art activities or not. The term includes

technicians or apprentices who work under the operator and perform body art activities.

denoting that the individual has received training as specified in these rules. The permit is

given in accordance with these rules and is separate from any other licensing requirement of

these rules for the body art facility or any local laws, rules, or ordinances.

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other non-governmental legal entity including but not limited to a corporation, partnership,

limited liability company, association, trust or unincorporated organization.

practice medicine in all its branches.

client's unclothed body during a body art procedure, skin preparation of the area adjacent to

and including the body art procedure or any associated work area which may require sanitizing.

reduce the numbers of microorganisms on cleaned surfaces and equipment to a safe level.

accidentally cut or penetrate the skin or mucosa including, but not limited to, pre-sterilized,

single use needles, scalpel blades and razor blades.

closed for handling, storage, transportation and disposal and is labeled with the International

Biohazard Symbol.

use and are disposed of after use on each client. This includes, but is not limited to, cotton

swabs or balls, tissues or paper products, paper or plastic cups, gauze and sanitary coverings,

razors, piercing needles, tattoo needles, scalpel blades, stencils, ink cups and protective

gloves.

area given to the client, and specific to the body art procedure(s) rendered.

microbial life, including highly resistant bacterial spores and is accomplished by the use,

according to manufacturer’s directions, of a properly functioning autoclave or dry heat sterilizer

that is manufactured to be used for sterilization.

the insertion of a pigment in or under the skin or an indelible design upon the body of another

individual by production of scars other than by branding.

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skin or mucosa of another individual by the aid of needles or any other instrument used to

puncture the skin, resulting in permanent coloration of the skin or mucosa. This includes all

forms of cosmetic tattooing.

fixed location where an operator performs body art procedures for no more than 14

days consecutively in conjunction with a single event or celebration.

and controls established by the Center for Disease Control and Prevention (CDC) for the

prevention of transmission of bloodborne pathogens (specifically; the human immunodeficiency

virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)).

(a) This method of infection control requires the employer and employee to assume that

all human blood and body fluids are potentially infectious.

(b) Precautions include hand washing, gloving, personal protective equipment, injury

prevention, and proper handling and disposal of needles, other sharp instruments, and blood

and body fluid-contaminated products.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

art procedures shall be performed in a body art facility which has a current, valid license issued

by the Department.

(a) No person shall perform any body art procedure upon a minor unless the person

obtains the prior, written, informed consent of the parent or legal guardian of the minor, as

shown in Appendix B, Consent for Minor.

(b) The parent or legal guardian of the minor shall execute the written informed consent

required in this rule in the presence of the individual performing the body art procedure on the

minor, or in the presence of an employee or agent of that individual.

upon another individual if, in the opinion of the operator, the other individual, or the consenting

parent or guardian, is under the influence of intoxicating liquor or a controlled substance.

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(a) The operator shall wear clean, intact, single-use gloves when performing body art

procedures.

(b) Under no circumstances shall a single pair of gloves be used on more than one

person. Gloves shall be changed if they become contaminated by contact with any non-clean

surfaces or objects or contact with a third person. The gloves shall be discarded at a minimum

after the completion of each procedure on an individual client and hands washed prior to

donning the next set of gloves.

(c) The use of single-use gloves does not preclude or substitute for hand washing

procedures as part of a good personal hygiene program.

(d) If, while performing a body art procedure the operator's glove is pierced, torn or

otherwise contaminated, the contaminated glove shall be immediately discarded and the hands

washed thoroughly (see section (5)(b) of this rule) before a new pair of gloves is applied. Any

item or instrument used for body art, which is contaminated during the procedure, shall be

discarded and replaced immediately with a new disposable or sterilized item or a new sterilized

instrument before the procedure resumes.

(a) The operator or technician shall maintain a high degree of personal cleanliness,

conform to hygienic practices, and wear clean clothes when performing body art procedures.

(b) Before performing body art procedures, the operator or technician must thoroughly

wash their hands in hot running water with liquid soap, then rinse hands and dry with disposable

paper towels. This shall be done as often as necessary to remove contaminants. Disposable

liquid soap dispensers shall not be refilled.

(c) Smoking, eating or drinking by anyone is prohibited in the work area where body art

is performed.

the premises of a body art facility and available for inspection by the Department:

(a) Full name and exact duties of each body art operator/technician;

(b) Date of birth of each body art operator/technician;

(c) Gender of each body art operator/technician;

(d) Home address of each body art operator/technician;

(e) Identification photos of each body art operator/technician;

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performed shall be kept on file on the premises of a body art facility and available for inspection

by the Department.

all sharps, and all inks used for any and all body art procedures, including names of

manufacturers and serial or lot numbers, if applicable, shall be kept on file on the premises of a

body art facility and available for inspection by the Department. Invoices or orders shall satisfy

this requirement.

(a) Biohazard waste, as defined in these rules, shall be disposed in accordance with all

applicable local, state, and federal laws, rules, and ordinances, to include, at a minimum, 29

CFR Part 1910.1030, Occupational Exposure to Bloodborne Pathogens.

(b) Waste which does not release liquid blood or body fluids when compressed or does

not release dried blood or body fluids when handled may be placed in a covered receptacle and

disposed through normal, approved disposal methods. Storage of such waste on-site shall not

exceed the period specified by the Department or more than a maximum of 30 days, as

specified in 29 CFR Part 1910.1030 whichever is less.

(c) Sharps ready for disposal shall be disposed of in approved biohazard sharps

containers.

(a) Any skin or mucosa surface to receive a body art procedure shall be free of rash or

any visible infection.

(b) The skin of the operator shall be free of rash or infection. No person or operator

affected with boils, infected wounds, open sores, abrasions, or weeping dermatological lesions

shall work in any area of a body art facility in any capacity in which there is a likelihood that they

could contaminate body art equipment, supplies or working surfaces with body substances or

pathogenic organisms.

Department that all operators and technicians have either completed or were offered and

declined, in writing, the hepatitis B vaccination series. This offering should be included as a

pre-employment requirement. Documentation of immunity, based on a blood test of the

operator, in written form and from an approved laboratory, may be used for this requirement of

proof.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

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procedures as part of patient treatment are exempt from these rules.

Department from investigating consumer complaints relating to alleged misuse or improper

disinfection of ear piercing systems.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

(a) Body art facilities shall prominently display a Disclosure Statement which advises

the public of the risks and possible consequences of body art services. The Disclosure

Statement shall be posted in a conspicuous place in the facility’s waiting or general public area,

and easily seen by potential clients wanting to receive a body art procedure.

(b) The Disclosure Statement shall include, at a minimum, the following wording in bold

type:

"There may be risks associated with the procedures of commercial body art which

includes permanent tattoos, body piercing and permanent cosmetic application, that may

adversely affect the healing process, or may be a concern due to potential disease

transmission, if you have, or have had, any of the following conditions:

a. History of Hepatitis B or Hepatitis C;

b. HIV/AIDS;

c. Diabetes;

d. History of hemophilia or any other blood disorder/disease;

e. History of skin diseases or skin lesions;

f. History of sensitivities to soaps, disinfectants, etc.;

g. History of allergies or adverse reactions to pigments, dyes, latex, etc.;

h. Tuberculosis;

i. Immune disorders;

j. History of epilepsy, seizures, fainting, or narcolepsy;

k. Scarring (keloids);

l. History of heart murmur or any heart disease/condition;

m. History of taking medications such as anticoagulants that thin the blood and/or

interferes with blood clotting;

(c) In the event a body piercing procedure is to be performed which involves the oral

area ("oral piercing"), the client should be given oral piercing information such as shown in

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Appendix C.

instructions for general site care which shall be provided as a minimum to each client. The

facility may provide additional information as it deems appropriate. The body art procedure site

care information shall be provided to each client by the operator upon completion of the

procedure. The written information sheet shall also contain the name, address and phone

number of the body art facility.

(b) The written information shall advise the client to consult a physician at the first sign

of infection; such as redness, swelling, drainage, prolonged pain at the body art procedure site,

or onset of fever.

who owns or operates a licensed tattoo facility shall, within 24 hours of becoming aware that an

individual tattooed, branded, or body pierced at the tattoo facility is infected with a

communicable disease, notify the department or a local county health department.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

(a) In order for the operator or technician to properly evaluate the client's medical

condition prior to receiving a body art procedure and not violate the client's rights or confidential

medical information, a written request for medical information shall be given to the client. The

request for medical information shall include, at a minimum, the conditions noted on the Model

Medical History shown in Appendix E.

(b) The operator should ask the client to sign this form confirming that the information

was obtained or attempted to be obtained.

(c) This form shall be signed and dated by both parties, with a copy given to the client

and the operator retaining the original with all other required records.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

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who have had body art procedures performed. The record shall include the name, date of birth,

and address of the client, the date of the procedure, name of operator who performed the

procedure(s), type and locations of procedure(s) performed, signature of client and if the client

is a minor, proof of parental or guardian consent, that is, signature.

by the client, shall be retained permanently and made available to the Department upon

request. The records for the previous three years shall be kept on the premises of the body art

facility; records older than three years may be kept offsite provided they are readily accessible

upon request of the Department. The Department and the body art facility shall keep such

records confidential.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

single service blades shall be used and discarded after each use. Following shaving, the skin

and surrounding area shall be cleaned with soap and water or an approved surgical skin

preparation, depending on the type of body art to be performed. When shaving is not done,

the immediate and surrounding area of the skin where the body art procedure is to be placed

shall be cleaned with soap and water or an approved surgical skin preparation. Cleansing pads

shall be discarded after a single use.

to check the flow of blood or to absorb blood shall be single-use and disposed of immediately

after use in appropriate covered containers, unless the disposal products meet the definition of

biomedical waste. 420-3-23-.09 Sanitation and sterilization procedures.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

body art shall be cleaned thoroughly after each use by scrubbing with an appropriate soap or

detergent solution and hot water or follow the manufacturer's instructions to remove blood and

tissue residue, and placed in an ultrasonic unit which shall also be operated in accordance with

manufacturer's instructions.

instruments used for body art shall be packaged individually in peel-packs and subsequently

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sterilized. All peel-packs shall contain either a sterilizer indicator or internal temperature

indicator. Peel-packs must be dated and may be used as long as the package integrity has not

been breached.

(a) All cleaned, non-disposable instruments and jewelry used for body art shall be

sterilized in a steam autoclave or dry heat sterilizer. Equipment used for sterilization shall be

used, cleaned, and maintained according to the manufacturer's instructions. A copy of the

manufacturer's recommended procedures for the operation of their sterilization unit must be

available for inspection by the Department.

(b) The use of equipment not specifically designed for medical instrument sterilization,

such as, but not limited to, food pressure cookers, microwave ovens, and baking ovens, is

prohibited.

been breached. If the package integrity is breached, the equipment shall be removed from the

package, and cleaned and sterilized as required in sections (1) and (2) of this rule.

work stations or areas frequented by the public. If the body art facility uses all single use,

disposable instruments and products, and utilizes sterile supplies, an autoclave shall not be

required.

shall demonstrate that the sterilizer used is capable of attaining sterilization by conducting

monthly spore destruction tests. These tests shall be verified through an independent

laboratory. The license shall not be issued or renewed until documentation of the sterilizer's

ability to destroy spores is determined by the Department. These test records shall be retained

by the operator for a period of three (3) years and made available to the Department upon

request.

sterilized prior to use and stored in peel-packs. After sterilization, the instruments used for

tattooing/body piercing shall be stored in a dry, clean cabinet or other tightly covered container

reserved for the storage of such instruments. All other instruments and supplies shall be stored

in clean, dry and covered containers.

used for equipment assembly, and any other similar surfaces where necessary shall be cleaned

and sanitized with a disinfectant solution after each client.

detergent and dried after each use. The cloth items shall be stored in a dry, clean environment

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until used. Soiled cloth items shall be stored in a manner to preclude contamination of any

clean items, equipment, or instruments.

shall remain stored in sterile packages until just prior to performing a body art procedure.

When assembling instruments used for performing body art procedures, the operator shall wear

disposable single-use gloves and use clean techniques to ensure that the instruments and

gloves are not contaminated.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

and equipment shall be specifically manufactured for performing body art procedures and shall

be used according to manufacturer's instructions and standard professional practice.

of the dye to be used shall be transferred from the dye bottle and placed into single-use paper

or plastic cups. Upon completion of the tattoo, these single cups and their contents shall be

discarded.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

reason. After use, all single-use needles, razors and other sharps shall be immediately

disposed of in approved sharps containers.

(a) All products applied to the skin, including body art stencils, shall be single-use and

disposable.

(b) Acetate stencils shall be allowed for re-use if sanitization procedures are performed

between uses.

(c) Petroleum jellies, soaps and other products used in the application of stencils shall

be dispensed and applied on the area to be tattooed with sterile gauze or in a manner to

prevent contamination of the original container and its contents. The gauze shall be used only

once and then discarded.

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(d) The operator shall use only single-use sterile gauze and single-use antibacterial

ointments to cover the procedure site(s).

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

rules shall submit a scale drawing and floor plan of the proposed facility for a plan review by the

Department, as part of the license application process.

(a) All walls and floors of the procedure area of a body art facility shall be smooth, free

of open holes or cracks, washable and in good repair. Ceilings in all procedure areas shall be

(b) Carpeting is prohibited as a floor covering in the body art procedure area.

(c) Walls, floors and ceilings in the body art facility shall be maintained in a clean

condition.

a) Water used for the sanitary operations of the body art facility shall be provided from

a source operated and constructed according to law.

(b) At least one water sample shall be collected annually from any body art facility if the

body art facility’s water supply is not from a source approved by the Alabama Department of

Environmental Management.

(c) If the water sample results show coliform present as reported by the Alabama

Department of Public Health Bureau of Clinical Laboratories, a resample shall be taken within

seven days of the report being received by the county health department. Whenever two

consecutive samples taken on separate days show coliform present, body art facility’s license

shall be suspended in accordance with appropriate administrative procedures. A sample result

of coliform absent with no confluent growth is required prior to reinstatement of the license.

disposed of by a public sewerage system or by a sewage disposal system constructed and

operated according to law.

Body Art Practice and Facilities 420-3-23

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(a) A readily accessible handwashing sink with hot and cold running water, under

pressure, dispensed through a mixing valve, with no aerator, preferably equipped with wrist or

foot operated controls, and supplied with liquid soap in disposable dispensers and disposable

paper towels at the sink, shall be provided convenient to the work area within any procedure

room in the body art facility.

(b) When there are multiple procedure areas or operators in one room, one

handwashing sink shall serve no more than three (3) operators or three (3) work areas.

(c) Toilet facilities shall be installed according to law; shall be the number required by

law as enforced by local plumbing officials, but at least one; shall be under the care and control

of the body art facility operator; and shall be accessible to employees at all times.

(d) Each toilet room shall have a handwashing sink, designed and supplied as required

in section (3)(a) of this rule, inside the toilet room or outside the toilet room immediately

adjacent to the toilet room door.

(e) Handwashing sinks shall be used for no other purpose.

(f) A utensil sink with hot and cold water under pressure, supplied through a mixing

valve with no aerator, shall be provided for washing reusable instruments or other reusable

items.

(g) A service sink or utility sink, with at least hot water under pressure, shall be provided

for the disposal of liquid waste.

benches, shall be of such construction and maintained to be easily cleaned and sanitized with a

disinfectant solution after each client.

by solid partitions or by walls extending from floor to ceiling, from any room used for human

habitation, or any room used for living or sleeping quarters or a bathroom used for a personal

residence, or from a food establishment or room where food is prepared, a hair salon, retail

sales, or other such activity which may cause potential contamination of work surfaces.

square feet of floor space at each work station in the body art facility unencumbered by non-portable

furniture or equipment. Each body art facility shall have an area which may be

screened from public view for clients requesting privacy. Multiple body art stations shall be

separated by dividers, curtains or partitions, at a minimum.

Body Art Practice and Facilities 420-3-23

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the body art operator to protect the entrance into the facility and the breeding or presence on

the premises of insects, vermin and rodents. Insects, vermin and rodents shall not be present

in any part of the facility, its appurtenances or appertaining premises.

except service animals used by persons with disabilities shall be allowed. Fish aquariums may

be allowed in waiting rooms and non-procedural areas.

each operator work area and each toilet room. Receptacles in the operator work area shall be

emptied daily and solid waste shall be removed from the premises at least weekly. All refuse

containers shall be lidded, cleanable and kept clean.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

(a) No person shall operate a body art facility until obtaining a license from the

Department. Any person desiring to operate a body art facility shall make written application

for a license on forms provided by the Department. Such application shall include the name

and address of each applicant, the physical location of the proposed body art facility, the type of

all body art procedures proposed to be conducted at the facility, and the signature of each

applicant. The license shall be issued on forms provided by the Department.

(b) If the Department determines that the application is complete and the body art

facility proposed or operated by the applicant meets the requirements of these rules, the

Department shall issue a license to the applicant for the operation of that body art facility.

(c) Licenses shall automatically expire on the date upon which state, county, and

municipal annual privilege licenses expire or on a date designated by the local county health

department and shall be renewable annually upon written application from the operator not less

than thirty (30) days prior to expiration.

(d) The body art facility applicant shall pay a fee as set by law for each body art facility

license, which is:

1. $250.00 for the initial annual license.

2. $200.00 for a one-year renewal of an annual license.

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3. $50.00 for a temporary license.

(e) Body art facility license fees are not prorated.

(f) A license for a body art facility shall not be transferable from one place or person to

another.

(g) A current body art facility license shall be displayed in a conspicuous place within

the customer service area of the body art facility where it may be readily observed by clients

upon entering the facility.

(a) The holder of a body art facility license shall hire, employ, or use operators or

technicians who have complied with the operator permit requirements of these rules.

(b) No person shall practice body art procedures without first obtaining an operator

permit from the Department.

(c) The operator permit shall be valid from the date of issuance and shall automatically

expire at the end of the facility license year following the current year when issued unless

revoked sooner by the Department in accordance with these rules. Application for operator

permits shall include:

1. Name;

2. Date of birth;

3. Sex;

4. Residence address;

5. Mailing address;

6. Phone number;

7. Place(s) of employment as an operator;

8. Years experience;

10. Proof of attendance within the 36 months prior to making application at a

bloodborne pathogen training program (or equivalent), given or approved by the Department, to

include demonstration of knowledge of the following subjects:

Body Art Practice and Facilities 420-3-23

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( i) Anatomy;

(ii) Skin diseases, disorders, and conditions (for example, diabetes) which may affect

the skin;

(iii) Infection control procedures including waste disposal, hand washing techniques,

sterilization equipment operation and methods, and sanitization/disinfection/sterilization

methods and techniques;

(iv) Facility safety and sanitation.

(d) Knowledge of the subjects in section 420-3-23-.13(2)(c)10 must be demonstrated

through submission of documentation of attendance or completion of courses approved or

given by the Department prior to issuance of the operator's permit. Examples of courses

approved by the Department would include such courses as Prevention of Disease

Transmission and Bloodborne Pathogen Training.

(e) No operator permit shall be issued unless, following reasonable investigation by the

Department, the body art operator has demonstrated compliance with the provisions of this

section and all other provisions of these rules.

(f) All operator permits shall be conditioned upon continued compliance with the

provisions of this section as well as all applicable provisions of these rules.

(g) All operator permits shall be posted in a conspicuous place within the customer

service area where they may be readily observed by clients upon entering the body art facility.

(a) Body art facilities operating at the time of the enactment of these rules, as

evidenced by the possession of a current and valid business license, shall, within 30 days of the

effective date of these rules, make application to the Department for a body art facility license

and pay the fee for a new license as required in this rule. This first license for these existing

facilities shall be considered a Provisional License and shall not be renewed unless all the

requirements of these rules are met by the license expiration date. In the event all the

requirements of these rules are not met by the time the Provisional License expires, or

application for a Provisional License is not made within 30 days of the effective date of these

rules, the body art facility shall not be considered an existing facility and shall make application

for a license as a new facility.

(b) Operators conducting body art procedures at the time of the enactment of these

rules shall make application to the Department for an Operators Permit and obtain an

Operators Permit within 6 months of the effective date of these rules.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

Body Art Practice and Facilities 420-3-23

19

(a) Temporary body art facility licenses and, when required, operator permits, may be

issued for body art services provided outside of the physical site of a fixed licensed facility for

the purposes of product demonstration, industry trade shows or for educational reasons.

(b) Temporary licenses issued under the provisions of these rules may be suspended

by the Department for failure of the holder to comply with the requirements of these rules.

(c) All facility licenses and operator permits and the disclosure notice must be readily

visible to clients.

issued unless:

(a) The applicant furnishes proof of compliance with 420-3-23-.13(2) relating to

operator's permits and/or

(b) The applicant is currently affiliated with a fixed location or permanent facility which,

where applicable, is permitted by the appropriate State and/or local jurisdiction; and

(c) The temporary site complies with section (9) of this rule.

approved by the Department within the past three (3) years as specified in 420-2-23-13(2)(c)

above, the applicant may furnish proof of attendance at equivalent training which is acceptable

to the Department.

after fourteen (14) days or the conclusion of the special event, whichever is less.

applicant has paid the fee set by law.

not be transferable from one place or person to another.

permit shall be posted in a prominent and conspicuous area where they may be readily seen by

clients upon entering the facility.

Body Art Practice and Facilities 420-3-23

20

(a) A temporary permit may be issued by the Department for educational, trade show or

product demonstration purposes only. The permit may not exceed fourteen (14) calendar days.

(b) A person who wishes to obtain a temporary demonstration permit must submit the

request in writing for review by the Department, at least thirty (30) days prior to the event. The

request shall specify:

1. The purpose for which the permit is requested;

2. The period of time during which the permit is needed (not to exceed fourteen

(14) calendar days per event), without re-application;

3. The fulfillment of temporary operator requirements as specified in section (2) of this

rule;

4. The location where the temporary demonstration will be conducted.

a) The temporary demonstration project must be contained in a completely enclosed,

non-mobile facility (that is, inside a permanent building).

operator shall comply with all of the requirements of these rules, including but not limited to:

1. Conveniently located handwashing facilities with liquid soap, paper towels and hot

and cold water under adequate pressure shall be provided; along with sanitary drainage in

accordance with local plumbing codes.

2. A minimum of eighty (80) square feet of floor space;

3. At least one hundred (100) foot candles of light at the level where the body art

procedure is being performed.

4. Facilities to properly sterilize instruments with evidence of a spore test performed on

sterilization equipment thirty (30) days or less prior to the date of the event, shall be provided;

or only single use, prepackaged, sterilized equipment obtained from reputable suppliers or

manufacturers shall be allowed;

5. Ability to properly clean and sanitize the area used for body art procedures.

The facility where the temporary demonstration is proposed shall be inspected by the

Department and a license issued prior to any body art procedures being performed.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

Body Art Practice and Facilities 420-3-23

21

(1) Prohibited acts include, but are not limited to, the following:

(a) Performing body art on any body part of a minor without the informed written

consent of the parent or legal guardian of such minor. This consent is to be given in person to

the operator or responsible person at the facility by the parent or legal guardian at the time the

tattooing or piercing is to commence.

(b) Performing body art on a person who, in the opinion of the operator is inebriated or

appears to be under the influence of alcohol or drugs.

(c) Owning, operating or soliciting business as a body art facility or operator without first

obtaining all necessary permits and approvals from the Department, unless specifically

exempted by these rules.

(d) Obtaining or attempting to obtain any body art facility license or operator permit by

means of fraud, misrepresentation or concealment.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

(a) A representative of the Department shall properly identify him or herself upon

entering a body art facility to make an inspection. Inspections shall be conducted at least every

180 days or as often as necessary throughout the year to ensure compliance with these rules.

(b) The routine inspection frequency shall be determined by the compliance status

(c) A routine re-inspection shall be conducted within 180 days when:

1. No critical items were found in non-compliance or any critical items found in non-compliance

are corrected during the inspection, or

2. No second-time repeat non-critical items were found in non-compliance.

(d) A compliance check shall be conducted within 30 days when:

Body Art Practice and Facilities 420-3-23

22

1. One or more critical items are found in non-compliance and are not corrected during

the inspection, or one or more repeat corrected critical items from the previous inspection were

found in non-compliance regardless of being corrected during the current inspection, or

2. One or more second-time repeat non-critical items from the previous routine

inspection were noted in non-compliance regardless of being corrected during the current

inspection.

(e) Whenever a compliance check to determine correction of any item finds the item in

continuing non-compliance; a Notice of Intent to Suspend or Revoke the license or permit shall

be issued to the person in charge at the body art facility. If the item in non-compliance and

being the cause for issuance of the Notice is corrected, the body art facility shall retain the

inspection status but shall be re-inspected within 30 days.

(a) The original of the inspection report (see Appendix F) shall be furnished to the

permit holder or operator of the body art facility, with the Department retaining possession of a

copy.

(b) The inspection report shall designate the compliance status of the body art facility

as Routine re-inspection or Compliance Check Necessary, based on the result of the inspection

as specified in 420-3-23-.16(1).

(a) Upon finding a violation of any provision of these rules that is deemed a non-critical

item, the Department shall advise the licensee or permitted operator, in writing, of its findings

and instruct the operator to correct such violations within a reasonable period of time, but no

later than the time of the next routine inspection.

(b) In the event a non-critical violation is not corrected by the time of the next routine

inspection, or is the same violation as on the preceding routine inspection, it shall be noted on

the inspection report as a repeat violation. In the event one or more non-critical items are found

in violation on a second consecutive routine inspection, they shall be noted on the inspection

report as a second repeat violation, and shall be corrected as required for critical items in 420-

3-.16(4).

(a) Violation of any provision of these rules that is deemed a critical item should be

corrected immediately, during the course of the inspection, but in any event within 30 days

following the inspection.

(b) In the event the violation cannot be corrected during the course of the inspection, or

if the critical violation is the same as on the immediately preceding inspection and was

corrected at that time but is now in violation again, notice of intent to suspend the body art

Body Art Practice and Facilities 420-3-23

23

facility license or operator permit, or both, shall be issued by the Department representative

conducting the inspection. The body art facility license holder or permit holder may request a

hearing on the notice of intent to suspend in accordance with these rules.

(a) Licenses and permits issued under the provisions of these rules may be suspended

temporarily by the Department for failure of the holder to comply with the requirements of these

rules or for repeated or critical violations of any of the requirements if these rules.

(b) Whenever the Department is aware of, or has reasonable cause to suspect that, 1)

a communicable disease has been, or may be, transmitted by an operator to a client; or 2)

there is use of unapproved or malfunctioning equipment; or 3) insanitary or unsafe conditions

exist which may adversely impact the health of the public; the Department may, upon written

notice to the owner or operator, do any or all of the following:

1. Issue an order excluding any or all operators from the licensed body art facility who

are responsible, or reasonably appear responsible, for the transmission of a communicable

disease until the Department determines there is no further risk to public health.

2. Issue an order to immediately suspend or revoke the license of the body art facility

until the Department determines there is no further risk to the public health. Such an order shall

state the cause for the action.

any time, make application for reinstatement of the permit. Within ten (10) days following

receipt of a written request, including a statement signed by the applicant that in his opinion the

conditions causing the suspension have been corrected, the Department shall re-inspect the

body art facility or evaluate documentation provided by an operator. If the applicant is in

compliance with the provisions of these rules, the license or permit will be reinstated.

(a) For failure to comply with a notice of license or permit suspension, or for repeated or

critical violations of any of the requirements of these rules, or for interference with Department

personnel in the performance of their duties, the license or permit may be permanently revoked

after a hearing. Before taking such action, the Department shall notify the license or permit

holder or operator in writing, stating the reasons for which the license or permit is subject to

revocation and advising the license or permit holder or operator of the requirements for filing a

request for a hearing. A license or permit may be suspended for cause, pending its revocation

or hearing relative thereto.

(b) A revocation shall last no less than 90 days. After that time, any person whose

license or permit has been revoked may make application for a new license or permit. If the

applicant is in compliance with the provisions of these rules as required for new applicants, the

new license or permit will be issued.

Body Art Practice and Facilities 420-3-23

24

comply with any notice issued under the provisions of these rules, the operator shall be notified

in writing that the license or permit is, upon service of this notice, immediately suspended. The

notice shall inform the license holder or permitted operator that an opportunity for a hearing will

be provided if a written request for a hearing is filed with the Department within fifteen (15)

days. Service of notice may be accomplished by mailing the notice, regular mail, to the address

listed on the body art facility license or operator permit application.

(a) A person who, 1. after proper application, is denied a permit, license, or

authorization; or 2. is in possession of a valid permit, license, or authorization, and is notified in

writing of the intent to suspend, revoke, or deny renewal of said permit, license, or

authorization, shall be provided the reasons therefore and may, within 15 days following receipt

of said notice, apply in writing for an informal hearing to the Health Officer, or his/her designee,

of the county from which said denial(s) or notice of intent was issued, in accordance with the

Rules of the State Board of Health governing appeals.

(b) If, after the informal hearing, the matter is not resolved to the satisfaction of the

aforesaid person, written appeal, in accordance with the Rules of the State Board of Health

governing appeals, may be made to the State Health Officer within 15 days following said

hearing. This appeal shall be sent directly to the State Health Officer, State Department of

Health, P.O. Box 303017, Montgomery, Alabama 36130-3017, with a copy furnished to the local

county health department of the county from which said denial or notice of intent was issued.

(a) Notwithstanding any other provision of these rules, whenever the Department finds

insanitary or other conditions which, in the judgment of the designee of the Department

authorized to conduct inspections of body art facilities, constitute a substantial hazard to the

public’s health, he or she may, without warning, issue a written notice to the license holder or

permit holder citing such conditions, specifying the corrective action to be taken, and specifying

the time period within which such action shall be taken.

(b) If deemed necessary, such order shall state that the license and/or permit is

immediately suspended, and all body art procedures shall be immediately discontinued.

(c) Any person to whom such order is issued shall comply immediately therewith.

(a) A person who violates any provision of these rules shall be guilty of a Class C

misdemeanor, punishable by imprisonment for not more than 90 days, or a fine of not more

than $100.00, or both, for each violation.

Body Art Practice and Facilities 420-3-23

25

(b) In addition to any other enforcement action authorized by law, a person alleging a

violation of Act 321-2000 may bring a civil action for appropriate injunctive relief.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

(1) Department personnel performing environmental health/sanitary evaluations or

complaint investigations of body art facilities shall meet the same requirements as specified for

operators in section 420-3-23-.13(2)(c)10 of these rules prior to assuming responsibilities for

this program.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

Any rules promulgated by the State Board of Health which are in conflict with these

rules, or with any portion thereof, are hereby expressly repealed.

AUTHORS: Ronald Dawsey and Charlotte Denton

STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.

EFFECTIVE DATE: May 4, 2001

Body Art Practice and Facilities 420-3-23

26

Critical items are those sections of these rules pertaining to:

Body art procedures performed on minors;

Body art procedures performed on clients under the influence;

Use of gloves by the operator;

Hygienic practices by the operator;

Operator’s hands washed and clean;

Biohazard and sharps disposal ;

Skin condition of the operator and client;

Evidence of Hepatitis B vaccination acceptance/declination for the operator on file and

available;

Site care information provided to clients as required;

Required client health information requested before any procedure;

Skin prepared as required before any procedure;

Instruments used for body art properly cleaned, sterilized, packaged, dated, stored, and

used;

Sterilizer tested (spore destruction) by independent 3

rd

party and documentation

available;

Body Art Practice and Facilities 420-3-23

27

Sterilizer manufacturer’s instructions for use available and followed;

Clean techniques used for assembly of instruments used for body art prior to beginning

procedure;

Inks, dyes, pigments, needles, other equipment used for body art procedures approved

and properly used;

Single-use items used as required;

Water supply from approved source;

Sewage disposal approved;

Waste water disposed through service sink;

Toilet(s) on premises, under care and control of operator, accessible, supplied and

designed as required;

Handwashing sinks used, provided, accessible, supplied, designed as required;

Utensil washing sink used, provided, accessible, supplied, and designed as required;

Service sink used, provided, accessible, supplied, and designed as required;

Insects, rodents, vermin, other animals not present unless specifically allowed by these

rules;

Display for public view of license, permits, disclosure statement.

Body Art Practice and Facilities 420-3-23

28

I, _________________________________, attest that I am the legal guardian of

___________________________________ who is currently __________ years of age and

that I give him/her consent to have the following procedure(s):

______________________________________________________

______________________________________________________.

I further attest that I have been informed of the possible risks involved with this

procedure and of its permanence by the undersigned individual performing the procedure or by an

employee or agent of the facility in which the procedure will be performed.

______________________________________________________________

Signature of Guardian

_______________________________________________________________

Address

________________________________________________________________

City,State, Zip Code

Date _______________________

___________________________

Signature of employee or Agent

Body Art Practice and Facilities 420-3-23

___________________________

Date

As a minor, I assent to this procedure. Yes________ No_________

Signature of minor having body art procedure Date

Body Art Practice and Facilities 420-3-23

30

Healing time for piercing and tattooing varies from person-to-person.

The rate of infection is minimal if the aftercare is followed appropriately. It is very

important to remember not to touch the pierced or tattooed site without first washing your

hands. Normal body reactions to piercing and/or tattooing may include: redness, swelling,

and/or minor discomfort at the site. If after 48 hours more severe complications occur

(increased redness, swelling or hardness at the site, pus-like drainage, onset of fever,

and/or prolonged pain at the site or respiratory difficulty following tongue piercing), contact

your personal physician or dentist (following oral piercing).

1. Do NOT remove jewelry except as instructed. Many people think that jewelry

can be removed after a few days or weeks. This is not true. Problems with re-insertion

and with the healing process may occur if jewelry is removed too soon. Usual

recommendations are for jewelry NOT to be removed for at least 6 months to a year. If

jewelry must be removed for medical reasons, call the piercer or your physician and

arrange to have it removed.

2. Never handle the piercing without first washing your hands.

3. Avoid being too rough with the piercing. This could traumatize the tissue at

the site.

4. Clean the pierced site as instructed. Do not over-clean using too many or

inappropriate cleaning agents.

5. Avoid swimming in rivers, lakes, or hot tubs until the piercing site has

completely healed.

1. Keep the new tattoo site bandaged for approximately 2 hours.

2. Wash hands prior to changing bandage.

3. Carefully remove bandage and wash entire area with a mild soap and cool

water. Dry the area and apply an antibiotic ointment using a very thin coat. Apply 2-4

times daily for at least three days.

4. Do NOT re-bandage the tattoo, as it could stick to the bandage and damage

could occur.

5. Avoid sunburn, salt or chlorine water, or hot tubs until your tattoo is

completely healed.

Body Art Practice and Facilities 420-3-23

31

6. In the event mild scabbing occurs, DO NOT pick at or attempt to "wash off".

Allow the scabs to slough off naturally. You may apply a mild skin lotion to keep "flaking"

to a minimum.

7. Note: In the first weeks, the colors in your new tattoo may look "hazy" or not

as bright as they did when it was first applied. Do not be alarmed, it is a normal course of

healing and will clear up in a few short weeks.

(Additional specific information sheets may be given to you as needed.)

MEDICAL HISTORY

Please Answer The Following Questions:

Do you presently have, or have you ever had:

1. Hepatitis B? Yes___ No___

2. Hepatitis C? Yes___ No___

3. HIV/AIDS? Yes___ No___

4. Diabetes? Yes___ No___

5. History of hemophilia or any other blood disorder/disease? Yes___ No___

6. Skin diseases or skin lesions? Yes___ No___

7. Sensitivities to soaps, disinfectants, etc.? Yes___ No___

8. History of allergies or adverse reactions to pigments, dyes,

latex, etc.? Yes___ No___

9. Tuberculosis? Yes___ No___

10. Immune disorders? Yes___ No___

11. History of epilepsy, seizures, fainting, or narcolepsy? Yes___ No___

12. Scarring (keloids)? Yes___ No___

13. History of heart murmur or any heart disease/condition? Yes___ No___

14. History of taking medications such as anticoagulants that

thin the blood and/or interferes with blood clotting? Yes___ No___

15. Are you now under the influence of alcohol or drugs? Yes___ No___

16. Are there any other medical conditions which may affect

your body art healing process? Yes___ No___

17. FEMALES: Are you pregnant or breast feeding/nursing? Yes___ No___

Signature:____________________________

Date:_________________________

Print Name:__________________________ Date of birth:__________________

Address:_______________________________________________________________

City, State, & Zip:________________________________________________________

Phone Number: ( )-____________________________________________________

Artist:__________________________________________________________________

For Tattooing:

Design & Body Site(s):____________________________________________________

Body Art Practice and Facilities 420-3-23

______________________________________________________________________

For Piercing: Type Jewelry & Body

Site(s):________________________________________________________________

For Branding: Design & Body

Site(s):________________________________________________________________

COMMENTS:

Inspection Report