Hive Tattoo Studio Client Consent Form

Hive Tattoo Studio Client Consent Form

If the client is a minor, the following must be included in the file: Proof of parental or legal guardian identification in the form of a photo identification. Acceptable forms of ID
Photo of Government issued I.D.*
Before starting a body art procedure, each person seeking a tattoo, branding or body piercing shall be asked about the following conditions:

History of skin disease, skin lesions, or skin sensitivities to soaps or disinfectantsHistory of hemophilia or excessive bleeding Diabetes or other conditions which may affect blood circulation and/or ability to fight infection.History of allergies or adverse reactions to latex, pigments, dyes, disinfectants, metals or other sensitivities related to body art proceduresHistory of epilepsy, seizures, fainting or narcolepsyTreatment with anticoagulants or other medications that thin the blood and/or interfere with blood clottingCurrently pregnancy and/or breast-feedingAny other information that would aid the body art technician or any other individual involved in providing education on the client's suitability for receiving a body art procedure and the client's body healing processAny client reporting one or more of the above conditions should be encouraged to consult their physician before undergoing a body art procedure. Indicate by checking the box that the client has
Indicate by checking the box that the client has*

Received a copy of the Disclosure Statement and Notice for Filing ComplaintsReceived a copy of the Aftercare Information SheetCompleted the Client Health Questionnaire, and received any additional, applicable information
I specifically acknowledge I have been informed of the facts and matters set forth below and I agree to the following . . .*

I am not under the influence of alcohol or drugs.I do not have acne, freckles, moles, or sunburn in the area to be tattooed that might be agitated by the tattoo process (healing excluded).I have looked over my design, checked the spelling if applicable, and give my full consent to the application of my tattoo.I acknowledge that I am not pregnant.I acknowledge that I am free of communicable disease.I acknowledge that I have truthfully represented to the associates, agents, and representatives of Hive Tattoo Studio that I am over eighteen (18) years of age.I acknowledge it is not reasonably possible for the associates, agents, and representatives of Hive Tattoo Studio to determine whether I might have an allergic reaction to the dyes, pigments, or processes used in my tattoo and I agree to accept such risks are possible.I acknowledge that infection is always possible as a result of obtaining a tattoo, particularly in that event that I do not take proper care of my tattoo, and I have been advised of the sign sand symptoms of infection that indicate a need to seek medical care.I acknowledge receipt of written instructions advising me of proper care of my tattoo and recognize the absolute necessity of following those written instructions. All questions about the body art procedure have been answered to my satisfaction.I acknowledge that variations in color and design may exist between any tattoos as selectedby me and ultimately applied to my body.I acknowledge that the obtaining of my tattoo is my choice alone and I consent to theapplication of the tattoo and to any actions or conduct of the associates, agents, orrepresentatives of Hive Tattoo Studio that are reasonably necessary to perform the tattoo procedureI agree to release or forever discharge and forever hold harmless Hive Tattoo Studio andit's associates from any and all claims, damages, or legal actions arising from orconnected in any way with my tattoo or the procedures and conduct used toapply my tattoo and any and all tattoos applied by Hive Tattoo Studio's associates.I acknowledge that tattoo inks, dyes, and pigments have not been approved bythe federal Food & Drug Administration and the health consequences of usingthese products are unknown.I acknowledge that there is a chance I might feel lightheaded and/or dizzy during or after being tattooed. I agree to immediately notify the practitioner in the event I feel lightheaded, dizzy, and/or faint before, during, or after the procedure.I give permission for Hive Tattoo Studio to photograph and video my tattoo duringand after my tattoo session. I Understand that the images and artwork may be used for social media,marketing, and other business uses.
I acknowledge that I have received a copy of the Disclosure Statement and Notice for Filing Complaints, received a copy of the Aftercare Information Sheet, and completed the Client Health Questionnaire and received any additional, applicable information. In addition, this record serves as signed documentation that the body art facility performing your tattoo, piercing, and/or branding is a licensed facility by the State of Michigan. It is recommended that individuals or organizations visit www.michigan.gov/bodyartto determine current the license status of the body art facility before proceeding with any.
Apprentice Artist*

I understand that my tattoo is being performed by an apprentice.I understand that there may be some application issues as a result of the learning process.I do not hold Hive Tattoo Studio or its artists liable for any mistakes in my tattoo as a result of the apprentices work.My tattoo is not being performed by an apprentice.
Client/Parent/Legal Guardian Signature*

Clear
Date*

MonthDayYear
Date
Date of Body Art Procedure*

MonthDayYear
Date
Name of body art technician performing the body art procedure*
Signature of body art technician

Clear
Client's Name*
What are your preferred pronouns

She/HerHe/HimThey/Them
Address*
Age/Date of Birth*

MonthDayYear
Date
Client Contact Information (used only in the event of a communicable disease outbreak investigation or other issues pertaining to client's health)
Telephone*
E mail Address*
example@example.com
Please describe the design and location of the tattoo, brand or body piercing*
The following may also be used to indicate the location of the body art:
Please include any known complication the client has with any tattooing, branding or body piercing performed at this body art facility.
Name of pigments used with batch numbers and expiration dates.

Solid BlackScab WFSCB190502 06/05/22Hemorrhage WFHRM1926062 0/7/23Laceration WFLCR212801 11/13/24Open Wound WFOW211304 11/14/24Rising Red IJY089050 1/31/23Crimson Red IE038778 12/22/22Dark Skin A021721 02/2025Vampire A011321 01/2025Fever A041621 04/2025Tangerine IE009648 5/6/22Bright Orange IE008624 4/25/22Acropolis Orange WFAO090909 4/22/23Bright Orange WCJBS12519 7/30/23ButanoA0322210 3/2025Thailand Sunset BWFTS203003 12/29/23Straight Orange WFSORG202300 4/20/24Solid Gold J091720 9/10/24Solid Gold IE065084 3/27/23Bumble Bee IE062932 2/8/23Canary Yellow WFCY211703 11/10/24Golden Gate WFGG20150 201/03/24Michealangelo Yellow 8/24/24Electric Raspberry ILC09946 02/14/23Cotton Candy IE056064 3/25/23Cotton Candy WCIBS03056 3/20/23Azaela WFAZLA1820020 3/11/23Strawberry WFSTRW200705 07/22/24Saigon Pink 59-0820200 8/20/23Flying Pig Pink WFFPP201203 10/22/23BombayLiberachi Red WFLR022040 1/06/2024Graveside Dark 142 05/22/22True Blue J100820 9/30/24Bermuda Blue IE0646540 5/07/22Sinatra Blue WFSB201606 07/29/24Jay Freestyle BlueDonatello Blue WFDTB200710 05/03/24Phantom Blue A0322210 3/2025Abyss Blue WFABYS192901 05/28/22Chill Blue A021721 02/2025Waterfall A021621 02/2025Mediterranean Sea WFMS190612 12/02/23Deep Amethyst WFTDA192602 12/21/22Red-Violet ILC04049 03/19/23Imperial Violet JLC01888 7/31/24Sinful Berry IBG05412 1/21/22Deepest Space IBG01402 2/22/22Exhaust IMC03530 3/15/22Purple Haze WFPHZ200412 04/04/24Light Purple JE017787 07/10/24Panama PurplePurple Rain WFPR191604 05/29/22Purple Heart WFPH202605 02/04/24Sage ILC226515 04/23/22Green Dragon IJY15909 02/01/23Graffiti Green IE033018 03/11/23Granny Smith Green ILC21948 02/15/23Margarita WFDGM202805 03/21/24Iceland Green WFIG201002 09/27/23Everglades Green WFEG202210 05/23/24Rain Forest WFRF200904 02/03/24Vegas Green WFVG191810 09/16/23Toxic Green A033021 03/2025Dark Gold A010821 01/2025Putrid Yellow A021721 02/2025Immovable Light IJY22075 03/26/23Tropical Teal IE053807 01/03/23Caribean Sea WFCS202207 07/21/24Galapagos Green WFGALG210601 08/15/24Dirty Scarlet IRP10741 12/11/22Dark Brown IE025743 12/13/22Brown IE026570 04/02/22Rust IEP16712 12/01/22Deep Red IE004636 04/30/22Flesh Tone IE027929 02/08/23Ochre IE037633 04/29/22Fair Honey WFPRFH190509 12/10/23Medium Skin A032521 03/2025Light Skin A032221 03/2025
include a driver's license, a passport, or state or government-issued identification that includes the parent's or legal guardian's name, picture and date of birth. A copy of the minor's birth certificate and/or court document verifying the parent's or legal guardian's relationship with the minor.

Note: The minor's parent or legal guardian must execute the written informed consent in the presence of the body art technician performing the body art procedure or another individual working in the body art facility.
Should be Empty: