Consent form

Date of procedure*

Date

Procedure category*

PiercingTattoo

Artist*

Gary

Description of procedure*

Example; lip piercing or tribal tattoo etc.

Procedure cost*

All prices are on website under Gary or prices tabs

Guardian name (where applicable)

First NameLast Name

Client name*

First NameLast Name

Date of birth*

Date

Guardians relation to client

Phone number*

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityCounty

Post code

Terms and conditions

Piercing: I confirm I am 16 or above and where relevent with a legal guardian if under 16.

Tattoo: I confirm I am 18 years or above.

I understand that I am familiar with the level of work the artist achieves. I have had all questions answered and verified all artwork. I am solely responsible for checking design for accuracy, spelling and grammar. I understand that upon leaving the studio I am happy with the outcome and take the responsibility for aftercare myself.

I have no conditions, illness (mental or physical), allergies and am taking no medication (prescription or over the counter). If I do I have raised it to my artist and written below the outcome of conversation.

I am not pregnant or under the influence of alcohol or recreational drugs. I am of sound mind and made this decision alone without any coercion.

Covid-19 prevention;

I acknowledge that although all risks of contracting covid-19 have been assessed by the studio and mitigated where possible, the studio is not liable if I do happen to contract during procedure.

By signing this form I am agreeing that all responsibility is on me solely that this procedure is right for me and that I am capable of taking all necessary precautions pre and post procedure. I am also agreeing to pay in full at the point of service.

Type a question*

I accept the above terms and conditions.

Please fill here if any conditions/medications were raised and how you were advised.

Signature*

Photo of ID if required, if you're filling out as a guardian please provide guardian ID in same photo too. Please bring the same ID's to the studio so it can be checked for damage or tampering.

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