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Consent Form
I can’t tattoo you with out this.
Please fill out accordingly.
Name
First Name
Last Name
Phone Number
Email
example@example.com
How did you hear about me?
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Do you currently have tattoos?
Yes
No
CONSENT FORM | Please agree to the terms and conditions
I acknowledge by signing this agreement that I have been given the lull opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the lacts and matters set forth below and I agree as follows:
If I have any condition that might affect the healing of this tattoo, I will advise my tattooer. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.
I do not have medical or skin conditions such as but not limited to aene, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer.
l acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.
I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to myown negligence. will be done at my own expense.
I realize that vanations in color and desien mav exist between ans tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin.
I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.
I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the abilit to later change or remove mv tattoo. Io my knowledee. I do not have a physical, mental or medical impairment or disability which might allect my well ocine as a direct of meirect result of my accision to nave a lattoo
I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to an actions or conduct o the representatives and employees o the tattoo shop reasonably necessary to perform the tattoo procedure.
Date
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Day
Year
Date
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