Name
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Please attach a clear, close-up and complete photo of your ID
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I acknowledge all of the following:
If I have a 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: acne, scaring (keloid), eczema, psoriasis, freckles, moles, or sunburn in the area to be tattooed that might interfere with said tattoo.
If I have any type of infection or rash ANYWHERE on my body, I will advise my tattooer.
I acknowledge it is not reasonably possible for the representative and employees of this shop to determine whether I might have an allergic reaction to the pigments or process 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 are of my tattoo.
I have recieved aftercare instrutions and I agree to follow them while my tattoo is healing.
I agree that any touch up work needed, due to my own negligence, will be done at my own expense.
I realize that variation in the color and design may exist between any tattoos I select and how they ultimately appear applied to my body. I understand that colors will appear differently on different skin tones and I have discussed my expectations with my tattooer.
I undersand that if I undergo any skin treatments, laser hair remobal, 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 ability to later change or remove my tattoo.
To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to be tattooed.
I acknowledge that I am over the age of 18 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 any actions or conduct of the representative any employees of the tattoo studio reasonably necessary to perform the tattoo procedure.
I have read and acknowledge all of the information above.
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