Ruby Tattoo Studio Tattoo Release Consent Form
Client Information
Full Name
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First Name
Last Name
Age
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Date of Birth
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Month
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Day
Year
Date
Upload Identification (Driver's License, Birth Certificate or Age of Majority card)
Browse Files
Cancel
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Phone Number
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Area Code
Phone Number
Email
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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I have maintained proper social distancing and have worked as hard as possible to follow all safety procedures to keep myself and others safe (hand washing, face masks, social distancing, isolation, etc.)
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I acknowledge I must wear a face mask in order to enter the studio. If I do not have one, Ruby Tattoo Studio will provide one and I will wear it throughout duration of my appointment without lifting it/removing it or having it fall below the nose.
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I acknowledge that tattoos done during discount flash events, fundraisers, charity events or for giveaways are subject to a touch-fee of a minimum of $40.00 - In agreeing to this, I am aware there are no free touch-ups for tattoos of these sorts and will have to pay out of pocket.
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I will follow all safety guidelines put in place at Ruby Tattoo Studio and maintain proper physical distancing from other staff and clients.
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I will not bring any food or drink into the studio (sealed new bottled beverages accepted.) nor will I remove/lift my mask to drink unless proper notice is given to my artist so they can maintain safe distance.
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I understand I will not be permitted to bring personal belongings into the shop except for my keys, phone, and purse/wallet.
Are you under the influence of drugs or alcohol?
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Yes
No
Are you Pregnant or Nursing?
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Yes
No
Are you currently on: Blood thinners, Immunosuppressants or antibiotics?
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Yes
No
If yes to medications above, what medication?
Please note: we are not liable for issues regarding medication and always seek getting medical approval from physician.
Do you have a communicable disease? (HIV, Hepatitis, etc.)
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Yes
No
Skin conditions (e.g. Rashes, Eczema, Rosacea, Infection, Psoriasis, Vitiligo, Sarcoidosis, etc.)
If yes, please identify the condition.
Medical History (e.g. Diabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)
If yes, please identify the condition.
Allergies:
Please list all allergies
Acknowledgment and Waiver
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I understand that this procedure is a permanent change to my skin and body.
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I have had and taken every opportunity to ask any questions and voice any concerns to my artist before the procedure and I am willingly proceeding with this permanent procedure and did my due diligence to be aware of all risks.
I will allow my tattoo to be photographed and be used for my artists and tattoo shops portfolio & social media to be showcased.
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I acknowledge that Ruby Tattoo Studio does not offer refunds on ANY products or services including but not limited to; Deposits, Gift certificates, Artwork, Tattoos, Commissions, Aftercare and Apparel. Everything is final sale, no exceptions.
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I agree that the studio does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo and will not be held accountable for any reaction that may arise and I am aware a reaction can take months or years to appear or develop.
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I am aware that my tattoo may be prone to fading over the years, especially if located in a high traffic area such as on hands or feet and I understand touch ups may not be free if located in high traffic area or if I fail to protect my tattoo properly from the elements including sun damage, poor aftercare, over-moisturizing, picking, etc.
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I acknowledge that there is risk of permanent scarring, raised ink / skin, keloids, infection, allergic reaction, and in extreme cases even death when getting any invasive procedures done. I agree to proceed with this procedure despite the risks and have had opportunity to research and dangers and risks associated to getting tattooed and release Ruby Tattoo Studio and all artists from liability should any complications arise.
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I acknowledge I have had ample opportunity to check over my design prior to being tattooed on my body. I release Ruby Tattoo Studio and the artists of all responsibility should any spelling errors of words, slight design variance or errors with dates occur.
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I acknowledge that I have ample opportunity to carefully examine the stencil and design to be tattooed on my body, I approve of the overall design and I understand that I have the opportunity to speak up, and if I proceed with the procedure then it is deemed correct and to my satisfaction upon being placed on my body and that it is my responsibility to communicate with my artist if any changes / repositioning is required prior to being tattooed.
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I acknowledge that the design may have variances from stencil, flash design drawing and digital design and that tattoo artists are only human and will work within the scope of their abilities and try to achieve the most accurate design. However line weights, shading, colour tone and saturation, fading stencils, skin integrity and body movements can affect the overall tattoo design. I understand these risks and still wish to proceed with the tattoo procedure.
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I understand that I need to take care of the tattoo by thoroughly following the aftercare instructions given to me by my artist and that if I fail to properly care for my tattoo, touch ups will be done at my own expense.
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I understand that I might get an infection if I don't follow the instructions given to me in regards of taking proper care of my tattoo and I will seek medical attention from my physician immediately should any complications arise.
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I acknowledge there is a chance I might feel light headed, nauseas, anxious and or dizzy during and after getting tattooed, as well as risk fainting.
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I agree to release and forever discharge and forever hold harmless Ruby Tattoo Studio and the artists and representatives from any and all claims, damages or legal actions arising from or connected in any way to my tattoo procedure.
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I acknowledge and understand that receiving a tattoo procedure involves inherent risks including but not limited to: Infection, allergic reaction, scarring, keloids, nerve damage, swelling, bruising, dissatisfaction with outcome or aesthetic, fading, migration of ink, poor healing and other known or unknown complications that may arise during or after the procedure. I confirm I am voluntarily choosing to undergo this procedure and that I have had the opportunity to ask question in regards to the procedure, aftercare, healing process and associated risks. I acknowledge that no guarantee or warranties, expressed or implied have been made to me regarding the final appearance, longevity or healing out come of the procedure. To the fullest extent permitted by law, I hereby release, waive, discharge and hold harmless Ruby Tattoo Studio and its owners, employees, subcontractors, apprentices, artists, representatives and affiliates from any and all claims, legal claims, demands, damages, actions, cause of actions, liabilities, losses, costs, or expenses of any kind whatsoever, whether known or unknown, forever or unforseen, arising directly or indirectly from my tattoo or piercing procedure, including any complications, dissatisfaction, injury, infection, scarring or adverse outcome.
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I further agree that I will not commence or maintain any lawsuit, claim, or legal proceedings against Ruby Tattoo Studio or any of its artists, employees or contractors in relation to the procedure or its outcome. I agree to indemnify and hold harmless Ruby Tattoo Studio and affiliates from and against all claims, damages, liabilities, legal fees, court costs, and expenses arising out of or related to: My breach of this agreement, my failure to follow aftercare instructions, false or misleading medical or personal information provided by me, any claims brought by me or on my behalf related to the procedure.
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If I am having previous work covered up or reworked from another artist, I acknowledge that my tattoo artist has no way to determine how much of the initial tattoo will show through and that we always recommend laser tattoo removal for darker, larger pieces. Our artists will try their best to cover original tattoo but it will likely result in numerous sessions, and there is a chance your older tattoo may slightly show through especially if it had scarring.
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I acknowledge that if I have placed a deposit for my appointment and deposits are non refundable and I know that I have had the opportunity to look up shop policies regarding deposits. Being late to my appointment or making last minute changes can result in loss of deposit, and the deposit is with the studio not a specific artist. If I do not book a follow up session within a year of deposit being placed, I am aware it will be forfeit and not held on file.
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I confirm that the information I provided in this document is accurate and true. By signing below I confirm that I have read, understood and voluntarily agree to the terms of this Release of Liability, Assumption of Risk, and Indemnity Agreement.
How did you hear about us?
Artist:
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Danii
Jaimee
Andrew
Barbara
Rachel
Hayley
Brooklyn
Sabrina
Johnny
Mack
Vanessa (Apprentice)
Mitt (Apprentice)
UNKNOWN (FLASH DAY)
GUEST ARTIST
Signed Date (enter full date)
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Month
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Day
Year
Date
Client Signature
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