Tattoo Consent Form

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Tattoo Consent Form

Please fill out the day of your appointment :)

First and last name *

Age *

Birth date *

YYYY

Phone number *

Email *

Pre- procedure Questions

Are you under the influence of any drugs or alcohol? *

Yes

If yes, please mention what you have taken

Are you pregnant or nursing? *

Yes

Do you have a communicable disease? *

Yes

Do you have any skin conditions? *

Yes

If yes, please indicate below

Please mention any relevant medical history (e.g. diabetes, cardiovascular disease, epilepsy etc.)

Acknowledgement and Consent

I understand that this procedure is a permanent change to my skin and body

I acknowledge that this tattoo is non-refundable

I acknowledge that I am liable for any unknown/new allergic reactions to products used by the tattoo artist

I agree to follow the aftercare instructions given to me by my tattoo artist

I understand the consequences of not following the aftercare

I confirm that the information I have put in this form is accurate and true

I consent to photos and videos of my tattoo being taken and potentially posted to social media (Optional!)

I would prefer to be tagged in any posts made about my tattoo

I would like to subscribe to a newsletter

Signed date

YYYY

Initial here please

Submit

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