Victory Art and Tattoo
Consent Form

PIERCING CONSENT

This Agreement is entered into by the above named Releaser and Victory Art and Tattoo, hereinafter known as the Releasee:

1. The Releaser fully and voluntarily consents to have the Releasee preform the procedure (s) and is fully aware and informed of all and any inherent risks, dangers, and complications that may occur as a result of the procedure (s) which may include but are not limited to: scarring, infections, allergic reactions, corneal abrasions, herpes (cold sore) outbreaks, eye injury, swelling, pain, bruising, minor bleeding, redness, soreness, etc. The Releaser fully understands that the nature of this procedure being used is a piercing process and is therefore not an exact science, but an art. The Releaser also understands and acknowledges that the piercing procedure may permanently alter the appearance of the Releaser’s body of which may not be desirable to the Releaser. The Releaser or the Releasee do not hold Victory Art and Tattoo responsible for any and all complications that may arise from the procedure 

2. The Releaser acknowledges that all questions, risks, dangers, and complications have been answered and explained and hereby agrees to forever release from all claims, damages, or liabilities that may result from the piercing procedure (s) as described in this agreement including costs of medical care that may arise from the procedure including post op-care. The Releaser acknowledges that Victory Art and Tattoo has made no other claims or guarantees other than is expressly written in this agreement.

3. The Releaser agrees to accept full responsibility for the placement, depth, and size of each and every procedure that the Releaser will have performed by the shop which is to include but not limited to: piercings of various parts of the body. The Releaser acknowledges receipt of pre-procedure information and post-procedure care instructions, has read them, has verbally been told them, understands them, and agrees to adhere to them in order to help prevent secondary infection.

4. The Releaser acknowledges that piercings can heal inconsistently, keloid (scarring), and they can migrate. It is the Releaser’s responsibility to schedule a follow-up to be done there weeks after the initial procedure, if needed. This touch up or revision will be done at no cost to the Releaser if scheduled within that time period (three weeks) after the initial procedure.

I certify that I have read, had explained to me, and fully understand the above consent and procedure permit, and that I accept full responsibility for any complications which may arise or result during or following the piercing procedure which is to be performed at my request. I also understand that no warranty or guarantee has been made to me as to the final results. Also, note area may be swollen/red, bleeding, crusty. If the Releaser is under the age of 18, a Parent or Guardian must sign on the behalf of the Releaser.

PIERCING APPRENTICE

1. The Releaser fully and voluntarily consents to have the Apprentice perform a permanent procedure (s) and is fully aware and informed of any and inherent risks, dangers, and complications that may occur as a result of the procedure (s) which may include but are not limited to: scarring, infections, allergic reactions, corneal abrasions, eye injury, swelling, pain, bruising, minor bleeding, redness, soreness,, etc. The Releaser fully understands that the nature of this procedure being used is a piercing process and is therefore not an exact science, but an art. The Releaser also understands and acknowledges that the piercing procedure may permanently alter the appearance of the Releaser’s body of which may not be desirable to the Releaser.

2. The Releaser acknowledges that all questions, risks, dangers, and complications have been answered and explained and hereby agrees to forever release the Apprentice from all claims, damages, or liabilities that may result from the tattooing procedure (s) as described in this agreement including costs of medical care that may arise from the procedure including post op-care. The Releaser acknowledges that the Apprentice has made no other claims or guarantees other than is expressly written in this agreement.

3. The Releaser agrees to accept full responsibility for the placement, depth, and size of each and every procedure that the Releaser will have performed by the Releasee which is to include but not limited to: piercings of various parts of the body.

4. The Releaser acknowledges the Apprentice is learning how to pierce, and understands the risks involved with the piercing procedure.

TATTOOING CONSENT

This Agreement is entered into by the above named Releaser and Victory Art and Tattoo, hereinafter known as the Releasee:

1. The Releaser fully and voluntarily consents to have the Releasee preform permanent procedure (s) and is fully aware and informed of all and any inherent risks, dangers, and complications that may occur as a result of the procedure (s) which may include but are not limited to: scarring, infections, allergic reactions, corneal abrasions, herpes (cold sore) outbreaks, eye injury, swelling, pain, bruising, minor bleeding, redness, soreness, hyperpigmentation,, etc. The Releaser fully understands that the nature of this procedure being used is a tattoo process and is therefore not an exact science, but an art. The Releaser also understands and acknowledges that the tattoo procedure may permanently alter the appearance of the Releaser’s body of which may not be desirable to the Releaser.

2. The Releaser acknowledges that all questions, risks, dangers, and complications have been answered and explained and hereby agrees to forever release the Releasee from all claims, damages, or liabilities that may result from the tattooing procedure (s) as described in this agreement including costs of medical care that may arise from the procedure including post op-care. The Releaser acknowledges that the Releasee has made no other claims or guarantees other than is expressly written in this agreement.

3. The Releaser agrees to accept full responsibility for the color, shape, style and thickness of each and every procedure that the Releaser will have performed by the Releasee which is to include but not limited to: tattooing of various parts of the body, cover-up tattoos, scar Camouflage. The Releaser acknowledges receipt of pre-procedure information and post-procedure care instructions, has read them, has verbally been told them, understands them, and agrees to adhere to them in order to help prevent secondary infection.

4. The Releaser may request a patch test prior to the tattoo procedure to determine allergic or other reactions to the pigments being used by the Releasee.

5. The Releaser acknowledges that cosmetic pigments can heal inconsistently, spread (migrate) or fan, and they can and will fade. It is the Releaser’s responsibility to schedule a touch-up to be done three to six weeks after the initial procedure. This touch up will be done at no cost to the Releaser if scheduled within that time period (three to six weeks) after the initial procedure. After six weeks, the Releaser agrees to pay a service fee for this and all future touch-ups. The Releaser acknowledges that performing a touch up over a previously performed procedure area performed by another Tattoo Technician may produce an allergic reaction, without the knowledge of the previous pigment or tattoo brand, color name, and all information pertaining to it.

6. The Releaser has been informed to wait one year after a tattoo procedure to give blood, not to drive for (1) hours after having a large procedure, that there are few effective methods for pigment removal, to advise medical personnel or professional esthetician’s of your tattoo if a chemical peel, MRI, or plastic surgery is to be performed near or over the tattoo, that the Releasee has advised the Releaser to obtain a prescription for Zovirax to prevent cold sores when having a lip tattoo, that the sun, chlorine water, and Glycolic acids or AHA’s, as well as Microdermabrasion may fade or effect the color of pigments being used, not to take aspirin, Ibuprofen, or blood thinners, prescription or otherwise, 10 days prior to the procedure, that anything applied to the procedure area during the first two weeks may cause an infection.

TATTOO APPRENTICE

1. The Releaser fully and voluntarily consents to have the Apprentice perform a permanent procedure (s) and is fully aware and informed of any and inherent risks, dangers, and complications that may occur as a result of the procedure (s) which may include but are not limited to: scarring, infections, allergic reactions, corneal abrasions, eye injury, swelling, pain, bruising, minor bleeding, redness, soreness, hyperpigmentation,, etc. The Releaser fully understands that the nature of this procedure being used is a tattoo process and is therefore not an exact science, but an art. The Releaser also understands and acknowledges that the tattoo procedure may permanently alter the appearance of the Releaser’s body of which may not be desirable to the Releaser.

2. The Releaser acknowledges that all questions, risks, dangers, and complications have been answered and explained and hereby agrees to forever release the Apprentice from all claims, damages, or liabilities that may result from the tattooing procedure (s) as described in this agreement including costs of medical care that may arise from the procedure including post op-care. The Releaser acknowledges that the Apprentice has made no other claims or guarantees other than is expressly written in this agreement.

3. The Releaser agrees to accept full responsibility for the color, shape, style and thickness of each and every procedure that the Releaser will have performed by the Apprentice which is to include but not limited to: tattooing of various parts of the body, cover-up tattoos, scar Camouflage.

4. The Releaser acknowledges the Apprentice is learning how to tattoo, and understands the risks involved with the tattooing procedure.