F.I.N.A.O. Ink Tattoo Consent Form

Name of Tattoo Artist *
Waiver, Release, and Consent to Tattoo

Please read and be certain you understand the implications of signing
Tattoo Description *
Are you getting a Hand or Foot tattoo?*

YesNo
Hand/Foot Tattoo Disclosure

Things to note when getting a hand/foot tattoo:
- Hands & feet are the most high-motion of areas on your body.
- Sides & bottoms of your hands and feet don't retain pigment the same way the rest of your body does.
- Clients should know that tattoos on the hands & feet tend to require touch-ups at a higher frequency than other tattoos because of the skin density, texture, elasticity, and motion.
- When we do a tattoo, we expect 95% & up of everything we tattoo to stay the way we tattoo, but when we tattoo hands & feet that percentage is more like 75% because of that high motion forcing pigment out. (this can happen very shortly after completion of tattoo even with proper aftercare.)
I have read & understand the above Disclosure. I proceed to move forward with the tattoo(s).*

Yes
Client Information

Please make sure to upload picture of photo ID, consent form will be denied without proper identification
UPLOAD VALID -IDENTIFICATION/LICENSE, PASSPORTS NO SELFIES PLEASE!! 🚫*
Full Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pre-Procedure Questionnaire
Are you under the influence of drugs or alcohol?*

YesNo
Are you pregnant or nursing?*

YesNo
Do you have a communicable disease/bloodborne virus (e.g. Hep B, Hep C, Hep D, HIV )?*

YesNo
Please list any skin conditions you have (e.g. rashes, eczema, infection, psoriasis, freckles, 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.
Please list any prescribed medication you take regularly (especially any blood thinners such as warfarin or aspirin, or any immunosuppressants such as steroids)*
If yes, please give details
Please list any allergic responses to metals, plasters, creams, latex, or anything else we should know*
If yes please give details
Any known/previous reaction to dye pigments?*
If yes, please give details
Acknowledgment and Waiver
Please check off*

I UNDERSTAND THAT THE TATTOO DEPOSIT AND TATTOO ITSELF IS NONREFUNDABLE.
Please check off*

I have been fully informed of the inherent risks associated with getting a tattoo. I understand that these risks, known and unknown, can lead to injury, including, but not limited to, infection, scarring, difficulties in detecting melanoma, and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo application, and I freely accept and assume any and all risks that may arise from tattooing.
Please check off*

I agree to waive and release to the fullest extent permitted by law each of the artists and F.I.N.A.O. Ink Tattoo Company from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors, or assigns may have for personal injury or otherwise, including any direct and/or consequential damages that result or arise from the application of my tattoo, whether caused by the negligence or fault of either the artist of the tattoo studio, or otherwise.
Please check off*

Both the artist and tattoo studio have given me the full opportunity to ask any and all questions about the application of my tattoo, and all of my questions have been answered to my total satisfaction.
Please check off*

The artist and tattoo studio have given me instructions for the aftercare of my tattoo while it’s healing, and I understand them and agree to follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touchup work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.
Please check off*

I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the artist without duress or coercion.
Please check off (Optional)

I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood-thinning medication. I do not have any other medical or skin condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed preventive regimen of antibiotic that is required by my doctor in advance of any invasive procedure such as tattooing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting a tattoo.
Please check off*

Neither the artist nor F.I.N.A.O. Ink Tattoo Company is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets.
Please check off*

Variations in color and design may exist between the tattoo art I have selected and the actual tattoo when it is applied to my body. I also understand that, over time, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin.
Please check off*

A tattoo is permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly, and which, in all likelihood, will not result in the restoration of my skin to its exact appearance before being tattooed.
Please check off (Optional)

I release all rights to any photographs taken of me and the tattoo. I give my consent in advance to their reproduction in print (if you do not check off this provision, please advise your artist and the tattoo studio NOT to take any pictures of you or your completed tattoo)
Please check off*

I agree to reimburse both the artist and the tattoo studio for any attorneys fees and costs incurred in any legal action I bring against either the artist or the tattoo studio and in which either the artist or the tattoo studio are the prevailing party. I agree that the courts of Rhode Island and Providence County shall have personal jurisdiction and venue over me, and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.
Please check off*

I acknowledge that I have been given an adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the artist and F.I.N.A.O. Ink Tattoo Company.
Please check off*

If any provision, section, subsection, clause, or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Please check off*

I hereby declare that I am of legal age (18) (and have provided valid proof of age) and I am competent to sign this agreement or, if not, my parent or legal guardian shall sign on my behalf, and my parent or legal guardian is in complete understanding and concurrence with this agreement.
Please check off*

I affirmatively consent to the use of electronic signatures and the use of electronic records to satisfy any statute, regulation, or rule of law requiring that the information contained in this agreement be provided in writing.
Please check off*

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.
Client Signature*

Clear
Signed Date*

MonthDayYear
Date
Do you have any questions for us?
Please check any that apply:*

Do send promotional emailsDo not send promotional emailsDo send postal mailDo not send postal mailDo send promotional text messagesDo not send promotional text messages
Referral (if applicable):
Name of person who referred you to F.I.N.A.O. Ink Tattoo Company
Should be Empty:

Waiver, Release, and Consent to Tattoo

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver