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Maryland's health regulations refer to tattooing and piercing as "Skin-Penetrating Body Adornment Procedures" (this excludes piercing of the earlobe). Tattoo artists are required to inform the client of the risks for the tattoo procedure, and must obtain the client's consent in writing. If the client is under the age of 18, their parent or guardian must sign the consent instead. The parlor is then required to keep this consent document for at least 3 years, along with the client's name, the date, a description of the procedure, and the artist's name who performed it.[17]

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